https://doi.org/10.55788/12811357
A large-scale, retrospective study conducted between 1 January 2006 and 31 December 31 2022, included 6,790 adult patients with a BMI ≥35 [1]. Participants were divided into 2 cohorts: those who underwent bariatric surgery and those treated with GLP-1 RAs (dulaglutide, exenatide, liraglutide, semaglutide, albiglutide, and lixisenatide) for at least 2 years. To account for potential confounders, the study utilised 1:1 propensity score matching, and several sensitivity analyses were performed to ensure the robustness of the findings.
The primary endpoints were the incidence of new-onset heart failure, composite cardiovascular events, and composite cerebrovascular events. The findings indicated that bariatric surgery was associated with a lower risk of adverse cardiovascular events than GLP-1 RA therapy. Specifically, the cumulative incidence of new-onset heart failure and cardiovascular events was lower in the bariatric surgery cohort at 2, 4, and 6 years of follow-up (see Table). While the cumulative incidence of cerebrovascular events was similar between the 2 cohorts at the 2-year mark, the bariatric surgery cohort exhibited a lower risk at the 4 and 6 years of follow-up.
Table: Outcomes in patients undergoing bariatric surgery and those receiving GLP-1 RAs [1]

GLP-1 RA, glucagon-like peptide-1 receptor agonists; RR, relative risk; CI, confidence interval.
The study highlights the potential cardiovascular benefits of bariatric surgery in patients with obesity, as it was associated with a reduced risk of adverse cardiovascular events compared with GLP-1 RA therapy.
- Soban M, et al. Bariatric surgery versus glucagon-like peptide-1 receptor agonists: a comparison of cardiovascular outcomes. Sa1949, DDW 2024, 18–21 May, Washington DC, USA.
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