top of page

Bariatric surgery is associated with a statistically significant risk reduction of CV outcomes

Bariatric surgery is associated with a statistically significant risk reduction of coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF) and cerebrovascular accident (CVA), according to findings from a systematic review and meta-analysis by researchers from in New York. The findings were featured in the paper, 'The Effects of Bariatric Surgery on Cardiovascular Outcomes and Cardiovascular Mortality: A Systematic Review and Meta-Analysis', published in Cureus.

The investigators carried out the meta-analysis to assess the effects of bariatric surgery on cardiovascular disease (CVD) outcomes and cardiovascular mortality, and included outcomes from Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and gastric banding (GB). The researchers included 49 studies; 32 studies were retrospective cohort studies, and other were prospective or population-based studies.


Seven studies reported effects on CAD, including 17,423 bariatric surgery patients and 43,507 controls. The effect on CAD was significant with a pooled HR of 0.68 (95% CI: 0.52-0.91) (p=0.008). Twenty-two studies reported myocardial infarction outcomes, including 23,1503 patients in the intervention group and 487,727 in the control group. The effect on MI was significant with a pooled HR of 0.53 (95% CI: 0.44-0.64) (p<0.01).

Eighteen studies reported heart failure outcomes, including 18,0961 in the intervention group and 202,891 in the control group. The effect on heart failure was significant with a pooled HR of 0.45 (95% CI: 0.37-0.55) (p<0.01). Eight studies reported atrial fibrillation outcomes, including 18,309 in the intervention group and 32,933 in the control group. The effect on atrial fibrillation was not significant with a pooled HR of 0.81 (95% CI: 0.65-1.01) (p=0.07 Twenty-three studies reported cerebrovascular accident (CVA) outcomes, including 238,472 subjects and 513,848 controls. The effect on CVA was significant with a pooled HR of 0.68 (95% CI: 0.59-0.78) (p<0.01).


Twenty-six studies reported cardiovascular disease-specific mortality, including 157,750 in the surgery group and 643,770 in the control groups. The effect on cardiovascular disease (CVD) mortality was significant with a pooled HR of 0.48 (95% CI: 0.40-0.57) (p<0.01).


“In this updated meta-analysis, we analysed six major long-term cardiovascular outcomes post-bariatric surgery. Five outcomes including CAD, MI, HF, CVA, and CVD mortality showed a significant risk reduction, whereas atrial fibrillation showed a non-significant risk reduction,” the authors stated.


“Although the management of obesity requires a multimodal approach, recognizing the necessity for bariatric surgery early in the disease course is important. Both the physician and the patients should be aware of the treatment strategies to make a well-informed decision…” the authors concluded. “Further research needs to be conducted to determine if these individual procedures have better overall outcomes than one another.”


To access this paper, please click here

Kommentare


bottom of page