{
  "abstract": "Aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) carry side-effects such as dizziness and nausea related to increased vagal tone. This study investigated associations between GLP-1 RA use and the risk of vagal activity-related (VAR) events.\n\nMethods and results: Using the Danish health registers, patients with type 2 diabetes mellitus (T2DM) first-time initiated on GLP-1 RAs (exposure) or sodium-glucose cotransporter-2 inhibitors (SGLT-2i) (active control) were identified between January 2010 and October 2022. Standardized 1-year absolute risks of VAR events (syncope, fractures, bradyarrhythmia, or cardiac device implantation) were computed to compare risk associated with GLP-1 RA and SGLT-2i initiation. Complementary analyses in patients treated for obesity were performed as well. During the study period, 50 076 and 73 138 patients with T2DM were initiated on GLP-1 RA [47% women, median age: 59 years (interquartile range {IQR}: 50–68)] or SGLT-2i [39% women, median age: 64 years (IQR: 55–72)]. Comorbidity was equally prevalent. The standardized 1-year absolute risk of syncope was 0.58% [95% confidence interval (CI): 0.51–0.66%] among patients initiated on GLP-1 RA and comparable to patients initiated on SGLT-2i [0.56% (95% CI: 0.50–0.62%)]. One-year risks of fractures, bradyarrhythmia, and cardiac device implantation were equally low and with corresponding standardized risk ratios of 0.90 (95% CI: 0.79–1.01), 0.97 (95% CI: 0.67–1.28), and 0.86 (95% CI: 0.62–1.10), respectively. No associations were found in the group treated for obesity either.\n\nConclusion: In nationwide cohorts of patients treated for T2DM or obesity, initiation of GLP-1 RA was not associated with an elevated risk of VAR events. Despite a proposed argumentation of vagal activity, GLP-1 RA use was not associated with an increased risk in real-life users.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "Lina Al-Ansary",
      "orcid": "0009-0006-0813-0661"
    },
    {
      "name": "Sebastian Kinnberg Nielsen",
      "orcid": "0000-0002-3157-8468"
    },
    {
      "name": "Mads Hashiba Jensen",
      "orcid": "0000-0002-3423-5495"
    },
    {
      "name": "Nina Nouhravesh",
      "orcid": "0000-0002-4891-7358"
    },
    {
      "name": "Caroline Sindet-Pedersen",
      "orcid": "0000-0001-9130-3506"
    },
    {
      "name": "Gunnar Gislason",
      "orcid": "0000-0002-0548-402X"
    },
    {
      "name": "Peter Vibe Rasmussen",
      "orcid": "0000-0002-4593-3854"
    },
    {
      "name": "Morten Lamberts",
      "orcid": "0000-0002-9827-440X"
    },
    {
      "name": "Anders Holt",
      "orcid": "0000-0002-8196-2599"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d1qpaaww24sb3.bib",
  "cited_by": 1,
  "doi": "10.1093/ehjcvp/pvag072",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730601/",
  "id": "d1qpaaww24sb3",
  "issns": [
    "2055-6837",
    "2055-6845"
  ],
  "landing_url": "https://doi.org/10.1093/ehjcvp/pvag072",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00200"
    ],
    [
      "heading",
      "AcademicSubjects/MED00410"
    ],
    [
      "heading",
      "Diabetes and Cardiometabolic Disorders"
    ],
    [
      "heading",
      "Eurheartj/1"
    ],
    [
      "heading",
      "Eurheartj/14"
    ],
    [
      "heading",
      "Eurheartj/23"
    ],
    [
      "heading",
      "Eurheartj/26"
    ],
    [
      "heading",
      "Eurheartj/6"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2712|Diabetes Treatment and Management"
    ]
  ],
  "openalex": "W7211948384",
  "pdf_url": "https://academic.oup.com/ehjcvp/advance-article-pdf/doi/10.1093/ehjcvp/pvag072/70997105/pvag072.pdf",
  "pmcid": "PMC13730601",
  "pmid": "42709513",
  "published": "2026-09-08",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/d1qpaaww24sb3.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:07Z",
      "native_id": "PMC13730601",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ehjcvp/pvag072"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Treatment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Vagal activity-related events and glucagon-like peptide-1 receptor agonists",
  "title_text": "Vagal activity-related events and glucagon-like peptide-1 receptor agonists",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:23:07Z",
  "url": "https://research.draconitic.com/paper/d1qpaaww24sb3",
  "venue": "European Heart Journal. Cardiovascular Pharmacotherapy",
  "versions": []
}