GLP-1 Drugs Linked to Lower Post-Surgery Heart and Infection Risks

Analysis Associates GLP-1 Medications With Reduced Surgical Risks

Patients taking glucagon-like peptide-1 (GLP-1) receptor agonists experienced lower rates of serious heart events and infections after elective surgery compared to non-users. Researchers presented the findings at the ANESTHESIOLOGY 2026 annual meeting hosted by the American Society of Anesthesiologists (ASA).

The observational study evaluated electronic health records from more than two million adults across the United States. Lead author Josephine Tolan, M.D., an anesthesiologist at McGovern Medical School at UTHealth Houston, analyzed the clinical outcomes alongside colleagues at the Center for Outcomes Research.

Specific Reductions Observed in Heart Complications and Infections

Matched patients taking GLP-1 drugs showed an 11% reduction in the odds of major cardiovascular complications compared to similar non-users. That combined outcome included myocardial infarction, cardiac injury, stroke, and postoperative death.

The analysis also detected an 8% reduction in the odds of developing common postoperative infections. The recorded infections included surgical site infections, urinary tract infections, pneumonia, and sepsis.

Data Drawn From Over Two Million Elective Surgical Records

The research team extracted records from the Epic Cosmos electronic health record database, which includes data from more than 1,700 hospitals and 40,000 clinics nationwide. The cohort included 2,028,601 adults aged 18 and older who had elective surgeries lasting longer than 60 minutes and required at least a 24-hour hospital stay between January 2016 and December 2024.

Among the total cohort, 145,610 individuals, or approximately 7%, had active prescriptions for GLP-1 medications. Researchers used statistical matching to balance GLP-1 users against similar non-users before comparing complication rates.

Biological Mechanisms That May Explain the Association

Surgery imposes intense physiological stress that elevates systemic inflammation and disrupts normal blood pressure and glycemic stability. The study authors noted that GLP-1 medications promote weight reduction, enhance blood pressure control, improve glucose stability, and reduce inflammation, which may protect the myocardium under stress.

Stable blood glucose regulation directly influences immune defenses, because elevated blood sugar impairs neutrophil function and weakens resistance to bacterial pathogens. Better perioperative glycemic control among GLP-1 users may therefore contribute to the lower observed incidence of surgical site infections and pneumonia.

Observational Design Leaves Causality Unproven

The study design cannot prove that GLP-1 medications directly caused the reduction in surgical complications. Because the investigators evaluated retrospective health records rather than conducting a randomized clinical trial, unmeasured health factors or variations in clinical management may have influenced the results.

Physicians still require controlled prospective trials to establish definitive perioperative guidelines for stopping or continuing these drugs around surgical procedures. Patients preparing for an upcoming elective operation should talk to their surgical and anesthesia teams about how to manage their current metabolic medications.