{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:43:11Z","timestamp":1790602991088,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM), but their effect on the risk of cardiovascular events and amputation in patients with chronic limb-threatening ischemia (CLTI) remains underexplored. This retrospective cohort study evaluated the association between GLP-1RA use and the 5-year risk of major amputation, all-cause mortality, and cardiovascular events in diabetic patients with CLTI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The TriNetX real-world clinical data platform was used to identify patients with T2DM and CLTI, categorized by GLP-1RA prescription records. Propensity score matching was applied based on demographics, comorbidities, concurrent medications, and laboratory values. Cox proportional hazards, Kaplan\u2013Meier curves, and the log-rank test were used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 139,173 patients with T2DM and CLTI, 17,306 patients were GLP-1RA users and 121,867 were non-GLP-1RA users. Following propensity score matching, 15,743 patients remained in each group (91% match rate). The mean age was 65.4 \u00b1 11 years and 58.9% were men. The mean follow-up duration was 753.7 days. GLP-1RA users had a significantly lower rate of major amputation (hazard ratio [HR]: 0.745; 95% CI: 0.679\u20130.816; log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), all-cause mortality (HR: 0.7; 95% CI: 0.663\u20130.738; log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and myocardial infarction (MI) (HR: 0.838; 95% CI: 0.792\u20130.886; log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). There was no difference in the risk of ischemic stroke (HR: 0.969; 95% CI: 0.906\u20131.036; log-rank\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.353).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The use of GLP-1RA medications is associated with a significant decrease in the 5-year risk of major amputations, all-cause mortality, and MI in diabetic patients with CLTI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x251393107","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:06:29Z","timestamp":1766052389000},"page":"47-53","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Benefits of glucagon-like peptide (GLP)-1 receptor agonists on 5-year risk of major amputation, all-cause mortality, myocardial infarction, and ischemic stroke in patients with chronic limb-threatening ischemia"],"prefix":"10.1177","volume":"31","author":[{"given":"Ashkan","family":"Yahyavi","sequence":"first","affiliation":[{"name":"University Hospitals Harrington Heart &amp; Vascular Institute, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maedeh","family":"Zokaei Nikoo","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen","family":"Hussein","sequence":"additional","affiliation":[{"name":"University Hospitals Harrington Heart &amp; Vascular Institute, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Katara","sequence":"additional","affiliation":[{"name":"Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime A","family":"Perez","sequence":"additional","affiliation":[{"name":"University Hospitals Center for Clinical Research, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4888-2431","authenticated-orcid":false,"given":"Mehdi H","family":"Shishehbor","sequence":"additional","affiliation":[{"name":"University Hospitals Harrington Heart &amp; 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