COMPARISON BETWEEN BARIATRIC SURGERY AND TIRZEPATIDE (MOUNJARO®) IN REDUCING CARDIOVASCULAR RISK IN OBESE PATIENTS
DOI:
https://doi.org/10.56238/levv17n56-003Keywords:
Bariatric Surgery, Tirzepatide, Obesity, Cardiovascular Risk, Integrative ReviewAbstract
Obesity is a chronic multifactorial disease associated with high cardiovascular morbidity and mortality, resulting from complex interactions among metabolic, hormonal, and inflammatory factors. In recent decades, surgical and pharmacological therapeutic strategies have been extensively investigated to reduce cardiometabolic risk in individuals with obesity. This study aimed to compare scientific evidence on the effects of bariatric surgery and tirzepatide (Mounjaro®) in reducing cardiovascular risk in obese patients. This is an integrative and comparative review with a qualitative–quantitative approach, developed from articles published between 2015 and 2025 in the PubMed, SciELO, ScienceDirect, and AHA Journals databases. Twenty studies were analyzed, including clinical trials, meta-analyses, and systematic reviews, of which fifteen demonstrated higher methodological relevance and were used in the comparative synthesis of findings. The results showed that bariatric surgery, particularly the Roux-en-Y gastric bypass and sleeve gastrectomy techniques, promotes a significant reduction in cardiovascular mortality, improvement in glycemic and lipid profiles, and a decrease in systemic inflammatory markers. Tirzepatide, in turn, demonstrated a marked impact on weight loss, insulin sensitivity, and improvement of inflammatory and hemodynamic parameters, with a cardioprotective effect comparable to that observed after metabolic surgery. It is concluded that both approaches constitute effective and complementary strategies for the prevention and management of cardiovascular diseases associated with obesity, representing promising perspectives for contemporary metabolic medicine.
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References
BORGES DIAS, L. et al. Comparação de desfechos cardiometabólicos entre agonistas de GLP-1 e cirurgia bariátrica em pacientes com síndrome metabólica. Lumen et Virtus, v. 16, n. 50, p. 1-15, 2025.
CAMARGOS BARROS, L. et al. A eficácia das técnicas da cirurgia bariátrica na remissão da diabetes mellitus tipo 2. Revista Eletrônica Acervo Saúde, v. 26, p. 101-110, 2021. DOI: 10.25248/reas.e8863.2021.
CHANDRAKUMAR, H.; KHATUN, N.; GUPTA, T.; GRAHAM-HILL, S.; ZHYVOTOVSKA, A.; MCFARLANE, S. I. The effects of bariatric surgery on cardiovascular outcomes and cardiovascular mortality: a systematic review and meta-analysis. Cureus, v. 15, e34723, 2023. DOI: 10.7759/cureus.34723.
DOUMOURAS, A. G. et al. Bariatric surgery and cardiovascular outcomes in adults with obesity. Circulation, v. 143, n. X, 2021. DOI: 10.1161/CIRCULATIONAHA.120.052386.
FERNANDES CARDOSO SANTOS-FURTADO, A. Aspectos fisiopatológicos da obesidade e suas repercussões cardiovasculares. Revista Brasileira de Cardiologia, v. 32, n. 4, p. 214-223, 2019.
HANKOSKY, R. M. et al. Effect of tirzepatide on predicted cardiovascular risk in obesity and diabetes: an integrated analysis. Diabetes, Obesity and Metabolism, v. 27, n. 2, p. 354-364, 2025. DOI: 10.1111/dom.15723.
KRISHNAN, A.; ZHANG, Y.; BROWN, E.; LEE, S.; MARTINS, D. Bariatric surgery and cardiovascular outcomes in metabolic dysfunction-associated steatotic liver disease and obesity. Metabolism, v. 150, p. 155366, 2025. DOI: 10.1016/j.metabol.2025.155366.
MENDES, K. D. S.; SILVEIRA, R. C. C. P.; GALVÃO, C. M. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto – Enfermagem, v. 17, n. 4, p. 758-764, 2008. DOI: 10.1590/S0104-07072008000400018.
MAMAS, M. A. et al. Tirzepatide in SURMOUNT-5: predicted 10-year cardiovascular risk reduction compared with semaglutide. European Heart Journal Open, 2025. DOI: 10.1093/ehjopen/oeaf117.
NICHOLLS, S. J. et al. Cardiovascular outcomes with tirzepatide versus dulaglutide in patients with type 2 diabetes and atherosclerotic cardiovascular disease. New England Journal of Medicine, 2025. DOI: 10.1056/NEJMoa2505928.
OLIVEIRA, T.; ROSÁRIO, R. Efeitos prospectivos da cirurgia bariátrica em marcadores de aterosclerose. Brazilian Journal of Health Review, v. 5, n. 2, p. 520-532, 2022. DOI: 10.34119/bjhrv5n2-004.
PACKER, M. et al. Tirzepatide for heart failure with preserved ejection fraction in patients with obesity. New England Journal of Medicine, 2025. DOI: 10.1056/NEJMoa2410027.
PESSÔA COSTA, A.; NUNES, R. L.; BARBOSA, F. L. Análise dos critérios da síndrome metabólica em pacientes antes e após cirurgia bariátrica. Brazilian Journal of Health Review, v. 4, n. 1, p. 43-55, 2021. DOI: 10.34119/bjhrv4n1-012.
STEFANOU, C.; BELLAS, C.; MARKOU, A.; ARGYROPOULOS, K.; POLYZOS, S. GLP-1 receptor agonists versus tirzepatide: cardiovascular events and mortality. Diabetes Therapy, v. 15, p. 145-161, 2024. DOI: 10.1007/s13300-024-01561-8.
VAN VELDHUISEN, S. L.; GORTER, T. M.; VAN WOERDEN, G.; DE BOER, R. A.; RIENSTRA, M.; HAZEBROEK, E. J. Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis. European Heart Journal, v. 43, n. 20, p. 1955-1969, 2022. DOI: 10.1093/eurheartj/ehac332.
