Evidence map›Paper›PMID 42700367›Full record

SynthesisEndocrinology, diabetes & metabolism2026

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

Erfan Shirmohammadi, Negar Ghasemloo, Navid Ebrahimi, Narjes Mohammadzadeh, Amir Ehtemami, Mahan Babaei, Shakiba Fardoost

Abstract readSystematic ReviewNetwork Meta-AnalysisComparative Study
In one paragraph

Synthesis in Endocrinology, diabetes & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Erfan ShirmohammadiDepartment of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0009-0007-5736-3418
Negar GhasemlooSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0009-0003-3730-2010
Navid EbrahimiSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0001-6722-6862
Narjes MohammadzadehDepartment of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0002-5541-1515
Amir EhtemamiIran Azad University of Medical Sciences, Tehran Medical Branch, Tehran, Iran.ORCID https://orcid.org/0009-0004-8844-100X
Mahan BabaeiSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0009-0000-8859-2909
Shakiba FardoostSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity, 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.

methodsA 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 I

resultsForty-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 (I

conclusionsBS 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.

Indexed as

Bariatric SurgeryCardiovascular DiseasesGlucagon-Like Peptide-1 Receptor AgonistsObesityHumansTreatment OutcomeGlucagon-Like Peptide-1 Receptor Agonistsbariatric surgerycardiovascular diseasescardiovascular risk reductionGLP‐1 receptor agonistsheart failuremajor adverse cardiovascular events (MACE)myocardial infarctionnetwork meta‐analysisobesitysystematic review

Identifiers

PMID42700367
PMCPMC13546078

What OpenQuestion holds

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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.