Comparative Cardiovascular Outcomes of GLP-1 Receptor Agonists Versus Bariatric Surgery: A Systematic Review and Network Meta-Analysis
- Design
- Meta-analysis · 932380 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different population[Auto] Synthesis of studies conducted predominantly in people with obesity/overweight.
- Could weight loss explain it?
- Possibly[Auto] Participants had obesity and/or type 2 diabetes and the abstract does not separate direct drug effects from weight loss or glycaemic improvement.
- Study tier
- Study tier 3[Auto] Systematic review/meta-analysis including observational studies (auto-provisional).
- Assessment
- Version 1 · automatic, not yet reviewed by a person · Sep 13, 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.
[Auto, unreviewed; quoted from abstract conclusions] BS demonstrated more consistent and statistically significant reductions in all cardiovascular outcomes compared to GLP-1RAs, which showed more variable efficacy, particularly for HF and MI. Nevertheless, GLP-1RAs remain effective evidence-based alternatives for cardiovascular risk reduction in patients who are not candidates for surgery, but future studies on newer GLP-1RAs are required. The high heterogeneity across studies highlights the need for cautious interpretation. These results may inform individualized treatment selection in patients with obesity at high cardiovascular risk.
01Findings
What the study reported
- Drugs
- Class unspecified
- Comparator
- controls
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- Not stated
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Obesity status
- obesity/overweight present (all or most)
- Cvd status
- cardiovascular disease present in population (see abstract)
- Sample size
- 932380
Study quality details
- Study design
- Meta-analysis
- Sample size
- 932380
- Randomization
- n/a
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- not stated
- Outcome type
- hard
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- CI reported: 95% CI 0
- Risk of bias
- not assessed (auto)
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- The authors declare no conflicts of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[BACKGROUND] Obesity, a major global health issue, heightens the risk of cardiovascular diseases, including major adverse cardiovascular events (MACE), heart failure (HF) and myocardial infarction (MI). This study provides the first network meta-analysis (NMA) integrating direct and indirect evidence to compare the cardiovascular efficacy of bariatric surgery (BS) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in individuals with obesity. [METHODS] A systematic review and NMA were performed in adherence to PRISMA guidelines. PubMed, Embase, Cochrane Library and Google Scholar were searched for studies published from January 2000 to September 2024. Eligible studies reported cardiovascular outcomes, specifically MACEs, HF and MI, in patients with obesity receiving BS, GLP-1RAs or control treatment. Fixed- and random-effects models were used to analyse hazard ratios (HRs) and risk ratios (RRs), with heterogeneity assessed with I2 and consistency through node-splitting analysis. [RESULTS] Forty-three studies involving 932,380 patients were included BS was associated with significantly greater reductions in MACEs (HR 0.66; 95% CI 0.60-0.74), HF (HR 0.45; 95% CI 0.38-0.53) and MI (HR 0.53; 95% CI 0.45-0.63) compared with controls in random-effects models. GLP-1RAs reduced MACEs (HR 0.85; 95% CI 0.77-0.94) but showed non-significant effects on HF and MI. Despite high heterogeneity (I2: 66%-93%), directional consistency was observed across studies. [CONCLUSIONS] BS demonstrated more consistent and statistically significant reductions in all cardiovascular outcomes compared to GLP-1RAs, which showed more variable efficacy, particularly for HF and MI. Nevertheless, GLP-1RAs remain effective evidence-based alternatives for cardiovascular risk reduction in patients who are not candidates for surgery, but future studies on newer GLP-1RAs are required. The high heterogeneity across studies highlights the need for cautious interpretation. These results may inform individualized treatment selection in patients with obesity at high cardiovascular risk.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Sep 13, 2026 | 42700367 first ingestion |