Reducing Early Stroke Recurrence Risk—Beyond Antithrombotics

About one-third of persons with ischemic strokes have diabetes, and an additional one-third have insulin resistance. After an ischemic stroke, diabetes is associated with approximately 20% higher risk of mortality, rehospitalizations, and ischemic stroke recurrence. Diabetes often occurs in the context of metabolic syndrome, obesity, hypertension, and dyslipidemia, which further compounds risk of downstream major cardiovascular adverse events. While treatments for dyslipidemia and hypertension have shown consistent reduction in cardiovascular events, clinical trials treating hyperglycemia were less consistent in demonstrating reduction of cardiovascular events. By addressing both hyperglycemia and weight management, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may have greater cardiovascular benefits than other glucose-lowering agents.