The Netherlands: Systematic review and meta-analysis of 39 controlled cohort studies revealed that bariatric surgery reduces the risk of all-cause and CV mortality, and cardiovascular diseases (CVDs) in obese patients. Therefore, the researchers suggest that, "bariatric surgery should be considered in these patients. The study was published in the European Heart Journal on 04 March 2022.
Obesity is a health problem prevalent across the entire world and is associated with significant morbidity and mortality, often due to CVDs. The surgery is being increasingly performed in patients with obesity due to its benefits with CV risk factors but its effect on CV disease is not established.
To fill the knowledge gap described above, Dirk J. van Veldhuisen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands, and colleagues aimed to evaluate the effect of bariatric surgery on CV outcomes, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline by conducting a systematic review and meta-analysis.
For this purpose, the researchers searched the online databases until August 2021 and included studies that compared bariatric surgery patients to non-surgical controls. Outcomes of interest were all-cause and CV mortality, atrial fibrillation (AF), myocardial infarction, heart failure (HF), and stroke. A total of prospective or retrospective cohort studies were included but there was no availability of randomized outcome trials.
The study revealed the following findings:
- Bariatric surgery was associated with a beneficial effect on all-cause mortality [pooled hazard ratio (HR) of 0.55 vs. controls], and CV mortality (HR 0.59).
- Bariatric surgery was also associated with a reduced incidence of HF (HR 0.50), myocardial infarction (HR 0.58), and stroke (HR 0.64), while its association with AF was not statistically significant (HR 0.82).
"The data from the present systematic review and meta-analysis strongly suggest that bariatric surgery reduces the incidence of CV disease and lowers mortality during follow-up," wrote the authors. "Bariatric surgery should therefore be considered in these patients."
Reference:
Sophie L. van Veldhuisen, Thomas M. Gorter, Gijs van Woerden, Rudolf A. de Boer, Michiel Rienstra, Eric J. Hazebroek, Dirk J. van Veldhuisen, Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis, European Heart Journal, 2022;, ehac071, https://doi.org/10.1093/eurheartj/ehac071
KEYWORDS: European Heart Journal, bariatric surgery, obesity, cardiovascular disease, mortality,Dirk J van Veldhuisen, obese, weight loss, CV, risk factors, heart failure, myocardial infarction, stroke, atrial fibrilaltion
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