Prior GLP-1RA or Tirzepatide Use and Early Cardiorenal Outcomes After Metabolic and Bariatric Surgery
In brief
Pre-surgery GLP-1RA or tirzepatide halves 90-day heart event risk after bariatric surgery
In a matched US cohort of 11,052 patients each, those who had filled a GLP-1RA or tirzepatide prescription before metabolic-bariatric surgery experienced 0.3% versus 0.6% rates of major cardiovascular events within 90 days, roughly a 50% reduction. Kidney complications were also lower (1.4% vs 2.3%). The findings suggest pre-operative metabolic optimization may improve early cardiorenal outcomes, but prospective trials are needed.
- Journal
- The American journal of medicine (Q1)
- Published
- 14 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Ting-Chun Tseng, Renin Chang
- PMID
- 42735883
- DOI
- 10.1016/j.amjmed.2026.09.010
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 18 September 2026): Prior GLP‑1/ tirzepatide use improves early post‑MBS outcomes
Abstract
OBJECTIVE: To compare early postoperative cardiovascular and kidney outcomes after metabolic and bariatric surgery (MBS) according to prior glucagon-like peptide-1 receptor agonist (GLP-1RA) or tirzepatide use. METHODS: This retrospective cohort study used the US Medical Records Database. Adults undergoing MBS from 2016 through 2025 were included. Prior use was defined by at least 1 GLP-1RA or tirzepatide prescription from 365 to 7 days before MBS; patients with prescriptions closer to surgery were excluded. Prior users and nonusers were propensity score matched 1:1. The primary outcome was 4-point major adverse cardiovascular events (MACE), and a key secondary outcome was early postoperative kidney events, assessed from postoperative day 1 through day 90. RESULTS: After matching, each group included 11,052 patients, with well-balanced baseline characteristics. Prior use was associated with lower risks of 4-point MACE (36 patients [0.3%] vs 67 patients [0.6%]; hazard ratio [HR], 0.535; 95% CI, 0.357-0.803) and early postoperative kidney events (158 patients [1.4%] vs 256 patients [2.3%]; HR, 0.613; 95% CI, 0.502-0.747). Prior GLP-1RA or tirzepatide use was also associated with lower risks of coronary events and heart failure. CONCLUSIONS: Among adults undergoing MBS, prior GLP-1RA or tirzepatide use was associated with lower 90-day risks of 4-point MACE and early postoperative kidney events. These findings support further investigation of preoperative metabolic optimization strategies and their potential role in improving postoperative cardiorenal outcomes.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.