Comparative Cardiovascular Outcomes of GLP-1 Receptor Agonists Versus Bariatric Surgery: A Systematic Review and Network Meta-Analysis.
Erfan Shirmohammadi, Negar Ghasemloo, Navid Ebrahimi et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated cardiovascular outcomes of bariatric surgery (BS) versus glucagon-like peptide-1 receptor agonists (GLP-1RAs) in obese patients. Among 932,380 patients, BS significantly reduced major adverse cardiovascular events (MACE) by 34% (HR 0.66), heart failure by 55% (HR 0.45), and myocardial infarction by 47% (HR 0.53) compared to controls, while GLP-1RAs reduced MACE by 15% (HR 0.85) but had non-significant effects on heart failure and myocardial infarction.
Key findings
- Bariatric surgery reduced major adverse cardiovascular events (MACE) by 34% (HR 0.66; 95% CI 0.60-0.74) compared to controls.
- Heart failure was reduced by 55% (HR 0.45; 95% CI 0.38-0.53) with bariatric surgery.
- Myocardial infarction decreased by 47% (HR 0.53; 95% CI 0.45-0.63) with bariatric surgery.
- GLP-1RAs reduced MACE by 15% (HR 0.85; 95% CI 0.77-0.94) but had non-significant effects on heart failure and myocardial infarction.
Why it matters
Understanding the comparative effectiveness of bariatric surgery and GLP-1RAs on cardiovascular outcomes is crucial for managing obesity-related cardiovascular risks. This information aids clinicians in making informed treatment decisions for patients at high cardiovascular risk.
What to keep in mind
High heterogeneity (I²: 66%-93%) across studies may affect the reliability of the findings.