{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:44:12Z","timestamp":1790009052593,"version":"4.0.1"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,7,5]],"date-time":"2017-07-05T00:00:00Z","timestamp":1499212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2017,11]]},"abstract":"\n Aims<\/jats:title>\n \n To assess the potential impact of glucagon\u2010like peptide\u20101 receptor agonist (\n GLP\u20101RA<\/jats:styled-content>\n ) exposure on cardiovascular disease (\n CVD<\/jats:styled-content>\n ) and mortality outcomes in patients with type 2 diabetes (\n T2D<\/jats:styled-content>\n ), using a large retrospective cohort.\n <\/jats:p>\n <\/jats:sec>\n \n Research Design and Methods<\/jats:title>\n \n Patients who had\n T2D<\/jats:styled-content>\n between 2005 and 2014 (N\u2009=\u2009105\u2009862) were identified from the electronic health record system at\n C<\/jats:styled-content>\n leveland\n C<\/jats:styled-content>\n linic using a validated electronic phenotype. A time\u2010dependent,\n C<\/jats:styled-content>\n ox, multiple regression analysis was used to assess the association between\n GLP\u20101RA<\/jats:styled-content>\n exposure and risk of acute myocardial infarction (\n AMI<\/jats:styled-content>\n ), stroke\/cerebrovascular accident (\n CVA<\/jats:styled-content>\n ), and overall mortality, as well as the composite of all three outcomes. The findings were further evaluated by assessing the effect of\n GLP\u20101RAs<\/jats:styled-content>\n on the same variables in patients with and without prior\n CVD<\/jats:styled-content>\n . The model adjusted for differences in demographic information, hypertension, laboratory\/vital signs, history of outcomes, and\n T2D<\/jats:styled-content>\n medications.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were significantly lower rates of\n AMI<\/jats:styled-content>\n (hazard ratio [\n HR<\/jats:styled-content>\n ] 0.80, 95% confidence interval [\n CI<\/jats:styled-content>\n ] 0.65 to 0.99;\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009=\u2009.045),\n CVA<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n 0.82, 95%\n CI<\/jats:styled-content>\n 0.74 to 0.91,\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009<\u2009.001), overall mortality (\n HR<\/jats:styled-content>\n 0.48, 95%\n CI<\/jats:styled-content>\n 0.41 to 0.57;\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009<\u2009.001), and the composite outcome (\n HR<\/jats:styled-content>\n 0.82, 95%\n CI<\/jats:styled-content>\n 0.74 to 0.91;\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009<\u2009.002) during the consolidated time that patients were exposed to\n GLP\u20101RAs<\/jats:styled-content>\n compared to corresponding rates during intervals without\n GLP\u20101RA<\/jats:styled-content>\n exposure.\n GLP\u20101RA<\/jats:styled-content>\n treatment was associated with a significant decrease in\n CVA<\/jats:styled-content>\n , mortality, and the composite outcome in patients with and without established\n CVD<\/jats:styled-content>\n , not significantly affecting\n AMI<\/jats:styled-content>\n in these subgroups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n GLP\u20101RA<\/jats:styled-content>\n exposure was found to be associated with a reduction in the risk of cardiovascular events observed and overall mortality among patients with\n T2D<\/jats:styled-content>\n with and without established\n CVD<\/jats:styled-content>\n , after adjusting for potential confounders.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.12969","type":"journal-article","created":{"date-parts":[[2017,4,13]],"date-time":"2017-04-13T14:04:36Z","timestamp":1492092276000},"page":"1555-1561","source":"Crossref","is-referenced-by-count":26,"title":["Association of glucagon\u2010like peptide\u20101 receptor agonist use and rates of acute myocardial infarction, stroke and overall mortality in patients with type 2 diabetes mellitus in a large integrated health system"],"prefix":"10.1111","volume":"19","author":[{"given":"Robert S.","family":"Zimmerman","sequence":"first","affiliation":[{"name":"Endocrinology Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Novo Nordisk Plainsboro New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Wells","sequence":"additional","affiliation":[{"name":"Clinical and Translational Science Institute Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon X.","family":"Kong","sequence":"additional","affiliation":[{"name":"Novo Nordisk Plainsboro New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Kattan","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Novo Nordisk Plainsboro New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Chagin","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Yu","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Sakurada","sequence":"additional","affiliation":[{"name":"Novo Nordisk Plainsboro New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Milinovich","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Weng","sequence":"additional","affiliation":[{"name":"Novo Nordisk Plainsboro New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine M.","family":"Bauman","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3897-4551","authenticated-orcid":false,"given":"Kevin 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