GLP-1 Receptor Agonist Use Before Total Knee Arthroplasty is Associated With Lower Postoperative MI, DVT, and VTE Rates
- Design
- Retrospective cohort · 23530 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Population unclearUNKNOWN: the abstract gives no age, BMI or diabetes status for the knee-replacement cohorts.
- Could weight loss explain it?
- PossiblyPossibly: propensity matching covered demographics, comorbidities and medications; no weight or glycaemic mediation was examined, so these are not separated from a drug effect.
- Study tier
- Study tier 3LOW: a single retrospective database cohort with propensity matching, capped at LOW; residual confounding remains possible.
- Assessment
- Version 4 · Two reviewers differed; settled by a recorded ruling · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
This US database study compared adults having a first total knee replacement who had a GLP-1 receptor agonist prescription in the year before surgery with matched patients who did not, with 11,765 in each group. GLP-1 use was linked to lower rates of heart attack (RR 0.528), deep vein thrombosis (RR 0.718) and venous thromboembolism (RR 0.772), but pulmonary embolism did not differ significantly (RR 0.847). These are associations from health records, not proof that the drugs caused the difference.
01Findings
What the study reported
- Drugs
- Glp-1 receptor agonists
- Comparator
- propensity-matched controls
- Dose
- various
- Primary outcome
- postoperative myocardial infarction, deep vein thrombosis, venous thromboembolism and pulmonary embolism
- Effect
- Myocardial infarction RR 0.528; deep vein thrombosis RR 0.718; venous thromboembolism RR 0.772; pulmonary embolism RR 0.847, not statistically significant
- 95% confidence interval
- 95% CI 0.325 - 0.858 (myocardial infarction)
- Follow-up
- Not stated
- Adverse events
- not reported in abstract
- Limitations
- Retrospective database study open to confounding by indication despite propensity matching; the abstract does not give follow-up length, dose or the reason for GLP-1 RA use.
Who was studied
- Obesity status
- not reported in abstract
- Diabetes status
- not reported in abstract
- Cvd status
- prior myocardial infarction excluded (as were prior DVT, VTE and pulmonary embolism)
- Ckd status
- not reported in abstract
- Baseline condition
- primary total knee arthroplasty
- Sample size
- 23530
- Inclusion exclusion
- adults with primary total knee arthroplasty, December 1, 2006 to June 1, 2025; prior MI, DVT, VTE or pulmonary embolism excluded
Study quality details
- Study design
- Retrospective cohort
- Sample size
- 23530
- Randomization
- no
- Blinding
- n/a
- Comparator
- propensity-matched controls
- Follow up duration
- not stated
- Outcome type
- hard
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- UNKNOWN
- Statistical precision
- CI reported: 95% CI 0.325 - 0.858 (myocardial infarction)
- Risk of bias
- not assessed
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- not reported in abstract
- Author conflicts
- The authors declare no conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are increasingly prescribed for glycemic control and weight management, but their association with postoperative thrombotic events after total knee arthroplasty remains unclear. We performed a retrospective cohort study using deidentified data from the TriNetX United States Collaborative Network, including adults who underwent primary total knee arthroplasty between December 1, 2006 and June 1, 2025. Patients with prior myocardial infarction, deep vein thrombosis, venous thromboembolism, or pulmonary embolism were excluded. Exposure was defined as a prescription for a GLP-1 RA within 1 year and 1 day before surgery. A 1:1 propensity score match was performed on demographics, relevant comorbidities, and medications, yielding 11,765 patients in each cohort. Outcomes were postoperative myocardial infarction, deep vein thrombosis, venous thromboembolism, and pulmonary embolism. Compared with matched controls, patients prescribed GLP-1 receptor agonists had a significantly lower risk of myocardial infarction (25/11,246 vs 47/11,171; risk ratio [RR] 0.528; 95% confidence interval [CI], 0.325 - 0.858). GLP-1 RA use was also associated with a reduced risk of deep vein thrombosis (74/11,319 vs 103/11,308; RR 0.718; 95% CI, 0.533 - 0.966) and venous thromboembolism (133/11,040 vs 172/11,027; RR 0.772; 95% CI, 0.617 - 0.967). In contrast, no statistically significant difference was observed in the incidence of pulmonary embolism between groups (49/11,352 vs 58/11,382; RR 0.847; 95% CI, 0.580 - 1.238). Overall, preoperative GLP-1 receptor agonist use was associated with a significantly lower postoperative risk of myocardial infarction, deep vein thrombosis, and venous thromboembolism following total knee arthroplasty in this large, nationally representative cohort.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Oct 18, 2026 | 42880346 first ingestion |