For most people, GLP-1 drugs are associated with diabetes and weight loss. But their potential benefits may go much further. Researchers found that people taking GLP-1 receptor agonists before elective surgery were less likely to experience serious cardiovascular complications or postoperative infections than those who were not using the drugs.
Josephine Tolan, MD, the study's lead author, told Newsweek she was particularly struck by the size of the associations, with GLP-1 use linked to an 11 percent reduction in the odds of major cardiovascular events and an 8 percent reduction in the odds of postoperative infections. "These findings are particularly interesting because GLP-1 medications are best known for their metabolic benefits," Tolan said. "Beyond their effects on appetite and satiety, these drugs may also modulate inflammatory pathways, which could help explain the associations we observed." She added that it was especially interesting to see the associations persist around the time of surgery, "when surgery typically triggers a substantial inflammatory response." Researchers at McGovern Medical School at UTHealth Houston set out to examine whether GLP-1 use could influence two major risks following surgery: cardiovascular complications and infections.
GLP-1 receptor agonists, a class of medications that includes semaglutide and tirzepatide-based treatments, were originally developed to help manage blood sugar in people with type 2 diabetes. In recent years, studies have also linked them to reduced risks of major cardiovascular events, but their effects around the time of surgery have remained unclear. To investigate, researchers analyzed data from the EPIC COSMOS database, a large electronic health record system that aggregates information from more than 1,700 hospitals and 40,000 clinics.
The study included 2,028,601 adults who underwent elective surgeries lasting longer than an hour and required at least 24 hours of hospitalization between January 2016 and December 2024. Of those patients, 145,610 were receiving GLP-1 therapy. After using statistical matching techniques to create comparable groups, the researchers examined rates of major adverse cardiovascular events, known as MACE, and infections following surgery.
MACE included heart attack, myocardial injury, stroke and death from any cause. Infection outcomes included surgical site infections, urinary tract infections, pneumonia and sepsis. The analysis found that major cardiovascular events occurred in 1 percent of GLP-1 users, compared with 1.1 percent of non-users.
Meanwhile, postoperative infections affected 4.9 percent of GLP-1 users and 5.3 percent of non-users. Overall, GLP-1 use was associated with an 11 percent reduction in the odds of major cardiovascular complications and an 8 percent reduction in the odds of postoperative infections. However, the findings also enter an ongoing discussion over how GLP-1 medications should be managed before surgery.
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