GLP-1 receptor agonists show potential as perioperative cardioprotective agents in cardiac surgery, though definitive clinical benefits remain unproven and current evidence is hypothesis-generating.
Do GLP-1 receptor agonists provide perioperative cardioprotection in patients undergoing cardiac surgery?
GLP-1 receptor agonists show potential as perioperative cardioprotective agents in cardiac surgery, but current evidence remains hypothesis-generating and requires prospective validation.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have rapidly evolved from glucose-lowering agents to central players in cardiovascular risk reduction. Evidence from landmark randomized controlled trials has established their capacity to reduce major adverse cardiovascular events, promote anti-inflammatory signaling, attenuate ischemia–reperfusion injury, and improve myocardial metabolic efficiency. As the prevalence of obesity, type 2 diabetes mellitus, and heart failure in the cardiac surgical population grows, GLP-1 RAs are increasingly encountered in the perioperative setting. Yet the cardiac surgery literature has yet to synthesize their emergent role coherently. This is a narrative review; no systematic review or meta-analysis was performed. This narrative review integrates mechanistic, clinical, and translational evidence to reframe GLP-1 RAs as potential perioperative cardioprotective agents in patients undergoing cardiac surgery. We examine receptor-level biology, evidence from the GLOBE randomized trial, observational data linking GLP-1 RA use to reduced postoperative atrial fibrillation after coronary artery bypass grafting, the rationale for the forthcoming REVERSE-TAVR trial, and evolving perioperative management guidelines. Key evidence gaps are identified, including the absence of prospective data in open cardiac surgery, aortic surgery, and high-acuity populations. We propose a research agenda and conceptual framework to guide future investigation into GLP-1 RAs as a new dimension of perioperative cardioprotection. The current evidence is hypothesis-generating; a definitive perioperative cardioprotective benefit has not yet been demonstrated in cardiac surgery populations, and these agents are presented here as potential rather than proven cardioprotective tools.
Androutsopoulou et al. (Fri,) conducted a review in Cardiac surgery. GLP-1 Receptor Agonists was evaluated. GLP-1 receptor agonists show potential as perioperative cardioprotective agents in cardiac surgery, though definitive clinical benefits remain unproven and current evidence is hypothesis-generating.