Preoperative GLP-1 Use Linked to Lower Atrial Fibrillation Risk After CABG: Study
USA: Preoperative use of glucagon-like peptide-1 (GLP-1) receptor agonists was associated with a lower incidence of new-onset atrial fibrillation following coronary artery bypass grafting (CABG), without an apparent increase in mortality or major adverse cardiovascular and cerebral events (MACCE), a new study has revealed. The findings suggest that GLP-1 therapy may offer perioperative benefits for patients undergoing CABG, although the researchers emphasized the need for further investigation.
The study, published in The Journal of Thoracic and Cardiovascular Surgery, was conducted by Irsa Hasan of the Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, and colleagues. Researchers examined whether GLP-1 receptor agonist use before surgery could influence outcomes among patients undergoing CABG, given the established cardiovascular benefits of these medications in people with diabetes and obesity.
Patients requiring CABG frequently have several of the same cardiovascular risk factors for which GLP-1 therapies are prescribed. However, the impact of these medications in the perioperative setting has been less clearly established.
For the study, investigators retrospectively analyzed data from a prospectively maintained cardiac surgery database. The analysis included patients who underwent nonemergent isolated CABG between 2010 and 2024. Patients were categorized according to whether they were taking GLP-1 receptor agonists before surgery. Multivariable Cox proportional hazards models were used to evaluate associations between GLP-1 use and all-cause mortality, MACCE, and 30-day mortality.
Key Findings:
- Among 11,389 patients undergoing isolated CABG, complete medication data were available for 4,170 patients.
- 165 patients (3.9%) were receiving GLP-1 therapy, with a median treatment duration of 353 days.
- GLP-1 users were generally younger, more likely to be women, and had higher rates of diabetes, hypertension, and elevated body mass index than nonusers.
- Patients taking GLP-1 medications had a longer intensive care unit stay, while overall hospital length of stay was similar between the groups.
- After adjustment for clinical factors, preoperative GLP-1 use was not significantly associated with all-cause mortality or major adverse cardiovascular and cerebral events (MACCE).
- New-onset postoperative atrial fibrillation was significantly lower among GLP-1 users than nonusers (14% vs 22%).
- Overall, preoperative GLP-1 use was not associated with increased major adverse outcomes after CABG and was linked to a lower incidence of postoperative atrial fibrillation.
The researchers noted that the association between preoperative GLP-1 use and reduced postoperative atrial fibrillation warrants further evaluation. Larger prospective studies will be needed to determine whether GLP-1 receptor agonists could have a protective role during the perioperative period and to clarify the mechanisms underlying this potential benefit.
Reference:
Hasan, I., Bessette, L. G., Jacquemyn, X., Wang, Y., Subramaniam, K., Hasan, Z., Thoma, F., Ogami, T., Bonatti, J., Kaczorowski, D., Chu, D., Serna-Gallegos, D., & Sultan, I. (2026). Association of GLP-1 inhibitors with cardiovascular outcomes in patients undergoing coronary artery bypass surgery. The Journal of Thoracic and Cardiovascular Surgery, 172(3), 591-599.e5. https://doi.org/10.1016/j.jtcvs.2026.02.005
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