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A recent mechanistic study using LDL receptordeficient mice and ox-LDLchallenged human endothelial cells demonstrated that liraglutide, one of the most widely studied GLP-1RAs, directly improves endothelial function by suppressing oxidative and inflammatory pathways ( in vitro experiments showed that liraglutide mitigated oxLDL-induced endothelial injury by suppressing NOX4 and NF-B signaling, and downregulating ICAM-1 and VCAM-1 expression ( 2.3 GLP-1RA modulation of promotion cholesterol efflux Beyond inflammation, impaired cholesterol efflux from macrophage-derived foam cells, mediated by key transporters such as ABCA1 and ABCG1, contributes to intracellular lipid accumulation and promotes plaque progression and instability ( A study in 2022 demonstrated that targeted GLP-1RA nanoparticles directly reduced vascular inflammation in ApoE/ mice, even at doses too low to affect glycemia or body weight ( Tnf and Icam1 expression with a concomitant increase in Arg1 , a marker of alternative macrophage activation