GLP-1 Drugs Around Heart Bypass Surgery: Fewer Readmissions, No Extra Complications | Research

The takeaway

Adults with congenital heart disease who used GLP-1 receptor agonists around their bypass surgery had 32% fewer hospital readmissions at one year with no increase in complications.

32% fewer readmissions
GLP-1 receptor agonist users had significantly lower one-year hospital readmission rates after coronary bypass surgery (OR = 0.68, p = 0.012)

What the researchers found

In adult congenital heart disease (CHD) patients who underwent coronary artery bypass grafting (CABG), perioperative use of GLP-1 receptor agonists was associated with a 32% reduction in one-year hospital readmission rates (OR = 0.68, p = 0.0118) compared to non-users after propensity score matching.

Importantly, GLP-1 RA use did not increase mortality (OR = 0.747, p = 0.35), nor did it increase rates of any postoperative complications including acute kidney injury, heart attack, stroke, or arrhythmia. Known GLP-1-related side effects like gastroparesis and abnormal weight loss showed no difference between groups. The study suggests GLP-1 agonists are safe to use around heart bypass surgery and may reduce the likelihood of hospital readmission.

Why it matters

GLP-1 receptor agonists are widely prescribed for diabetes and obesity, but surgeons and anesthesiologists have been cautious about their use around surgery due to concerns about gastroparesis and aspiration risk. This study provides reassuring evidence that these drugs don't increase surgical complications and may actually improve outcomes by reducing readmissions in a high-risk cardiac population.

The numbers in context

n=720 (360 per group) · 32% lower readmission rate (OR=0.68, p=0.0118) · No mortality difference (OR=0.747, p=0.35) · No increase in GLP-1-related complications · 2005-2025 data

How the study worked

Retrospective cohort study using de-identified patient data from the TriNetX Research Network (2005-2025). Adult CHD patients who underwent CABG were divided into GLP-1 RA users (within 3 months before or 1 month after surgery) and non-users. Propensity score matching (1:1) balanced 360 patients per group on demographics, comorbidities, and CHD diagnoses. Outcomes measured at one year included mortality, readmission, postoperative events, and GLP-1-related complications.

Who was studied

Adult congenital heart disease patients undergoing coronary artery bypass grafting

What this study cannot tell us

Retrospective design cannot establish causation — the readmission benefit could reflect healthier patients or better overall care. TriNetX database studies rely on billing codes, which may miss undocumented drug use or misclassify diagnoses. The GLP-1 RA group likely included patients with diabetes or obesity (indications for the drug), which despite matching could introduce residual confounding. Published in Cureus, which has a less rigorous peer review process.

How to read the evidence

This is a propensity-matched retrospective cohort study — a common and accepted design for surgical outcomes research, but it cannot prove causation. The large database (TriNetX) provides good statistical power, but the reliance on billing codes and the Cureus publication venue moderate the evidence strength.

When this study was published

Published in 2025 using data from 2005-2025. Highly current and directly relevant to the ongoing debate about perioperative GLP-1 agonist management.

The bigger picture

As millions of people start GLP-1 drugs for weight loss and diabetes, surgeons increasingly face the question: should patients stop these drugs before surgery? There have been concerns about aspiration risk from delayed gastric emptying. This study adds to a growing body of evidence suggesting GLP-1 agonists don't worsen surgical outcomes and may even help — particularly relevant for cardiac surgery patients who face high readmission rates.

Questions still open

Would a prospective randomized trial confirm the readmission benefit, or is it an artifact of patient selection?
Should perioperative GLP-1 RA guidelines be updated for cardiac surgery patients based on accumulating safety data?
Does the anti-inflammatory effect of GLP-1 agonists contribute to the readmission reduction, or is it primarily a metabolic benefit?

Common questions

Should patients stop GLP-1 drugs before heart bypass surgery?

This study suggests they may not need to. Patients who used GLP-1 receptor agonists around their bypass surgery had fewer hospital readmissions and no increase in complications, including no increase in gastroparesis or aspiration-related events. However, this is a retrospective study, so patients should follow their surgeon's specific guidance.

Why were hospital readmissions lower in the GLP-1 group?

The study doesn't identify a specific mechanism, but GLP-1 agonists have known anti-inflammatory and cardioprotective properties beyond their metabolic effects. These may help with post-surgical recovery. It's also possible that GLP-1 users had better-managed diabetes and weight, contributing to smoother recoveries.

Read the original research

Perioperative Use of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Lower Readmission Rates After Coronary Artery Bypass Grafting (CABG) in Adults With Congenital Heart Disease.

Cureus, 17(10), e95767

View on PubMed ↗Publisher’s paper ↗

Citation

Yan, Jason H; McKinnerney, Joey; Al Janabi, Taysir; Chahal, Anwar; Malik, Adnan; Vranian, Michael N; Kashyap, Rahul. (2025). Perioperative Use of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Lower Readmission Rates After Coronary Artery Bypass Grafting (CABG) in Adults With Congenital Heart Disease.. Cureus, 17(10), e95767. https://doi.org/10.7759/cureus.95767