Metabolic and bariatric surgery versus glucagon-like peptide-1 receptor agonist therapy: A comparison of cardiovascular outcomes in patients with obesity

📖 Top 20% JournalFeb 18, 2025American journal of surgery

Heart health after weight-loss surgery compared to medication in people with obesity

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Abstract

MBS was associated with a lower hazard of cardiovascular disease compared to GLP-1 RA therapy.

The primary composite outcome of cardiovascular disease included heart failure, coronary artery disease, and cerebrovascular disease.
Patients undergoing metabolic and bariatric surgery had a hazard ratio of 0.54 for cardiovascular disease.
Incident heart failure was associated with a hazard ratio of 0.45 following metabolic and bariatric surgery.
Coronary artery disease showed a hazard ratio of 0.54 in patients who underwent metabolic and bariatric surgery.
Cerebrovascular disease was associated with a hazard ratio of 0.64 in the metabolic and bariatric surgery group.

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BACKGROUND: This study compared cardiovascular outcomes associated with metabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in individuals with obesity.

METHODS: The TriNetX network was used to compare cardiovascular risk in adult patients with BMI ≥35 who underwent MBS with those who received GLP-1 RA therapy for ≥2 years. Primary outcome was cardiovascular disease (CVD), a composite of incident heart failure (HF), coronary artery disease (CAD), and cerebrovascular disease. Patient follow-up lasted up to 10 years.

RESULTS: MBS was associated with lower hazard of the primary composite outcome of CVD (HR, 0.54, 95 % CI, 0.49-0.60), and the secondary outcomes of incident HF (HR, 0.45, 95 % CI, 0.39-0.52), CAD (HR, 0.54, 95 % CI, 0.45-0.66), and cerebrovascular disease (HR, 0.64, 95 % CI, 0.53-0.77).

CONCLUSIONS: A lower risk of adverse cardiovascular outcomes was noted after MBS compared with GLP-1 RA therapy in patients with obesity.

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Abstract

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