Evidence map›Paper›PMID 41644868›Full record

SynthesisObesity surgery2026

Comparing Cardiovascular Outcomes of GLP-1 Receptor Agonists Versus Metabolic Bariatric Surgery: A Systematic Review and Meta-Analysis.

Dorsa Shekouh, Mehrdad Behboodi, Matin Varmazyar, Alireza Khodadadiyan, Parnia Jochin, Hamed Bazrafshan Drissi

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dorsa ShekouhCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Mehrdad BehboodiCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Matin VarmazyarCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Alireza KhodadadiyanCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Parnia JochinCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Hamed Bazrafshan DrissiCardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. hamedbazrafshan@yahoo.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionObesity significantly increases cardiovascular risk through insulin resistance, dyslipidemia, hypertension, and systemic inflammation. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and metabolic bariatric surgery (MBS) are effective weight-loss interventions that may improve cardiovascular outcomes. However, evidence comparing the long-term cardiovascular benefits of GLP-1RAs versus MBS remains limited. We systematically compare the impact of GLP-1RAs versus MBS on cardiovascular outcomes, including major adverse cardiovascular events (MACE), and heart failure (HF) in patients with obesity.

methodsWe conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, and Embase were searched up to July 30, 2025, for studies comparing cardiovascular outcomes of GLP-1RAs and MBS. Inclusion criteria encompassed studies reporting cardiovascular disease (CVD), including MACE and HF. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were performed using the R meta package. Heterogeneity was evaluated with I² statistics, and publication bias was assessed via funnel plots and Egger's test.

resultsSix cohort studies, including over 282,450 participants, compared cardiovascular outcomes of MBS versus GLP-1RAs. MBS was associated with a significantly lower prevalence of CVD (RR = 0.63; 95% CI: 0.49-0.81; I² = 87.7%) and HF (RR = 0.50; 95% CI: 0.37-0.66; I² = 70.2%) compared to GLP-1RAs. For cerebrovascular events, a non-significant trend favored MBS (RR = 0.68; 95% CI: 0.34-1.36; I² = 91%). Sensitivity analyses confirmed the robustness of these findings, and no significant publication bias was detected.

conclusionsCompared to GLP-1RAs, metabolic bariatric surgery is linked to better cardiovascular outcomes and a decreased prevalence of heart failure in individuals with obesity. Although trends point to possible cerebrovascular benefits, there is insufficient research to draw firm conclusions. These findings might help physicians tailor their approaches to managing obesity in order to maximize the reduction of cardiovascular prevalence.

Indexed as

Bariatric SurgeryCardiovascular DiseasesGlucagon-Like Peptide-1 Receptor AgonistsObesityHumansGlucagon-Like Peptide-1 Receptor AgonistsBariatric surgeryCardiovascular outcomesCerebrovascularGLP-1 receptor agonistsHeart failureObesity

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.