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Aims <p>This study compares the effectiveness of sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) on the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk and identifies key factors influencing postoperative (post-op) changes in ASCVD risk.</p> Methods <p>This prospective cohort study assessed the 10-year ASCVD risk in patients undergoing SG or OAGB between 2013 and 2023 using the ACC/AHA ASCVD Risk Estimator. In addition to the baseline assessment, the risk score was evaluated at 6, 12, 24, 36, and 48 months post-op. Longitudinal analysis tracked changes in ASCVD risk, and regression models identified individual and combined factors influencing these changes.</p> Results <p>The analysis enrolled 1397 individuals (mean age 50.1 years, 87.9% female), including 952 SG and 445 OAGB participants. Following adjustments, the 10-year ASCVD risk significantly reduced post-op with no observed differences between the surgical groups. Positive associations with risk reduction were found for baseline risk, total cholesterol (TC), type 2 diabetes mellitus (T2DM), triglycerides (TG), systolic blood pressure (SBP), fasting plasma glucose (FPG), and estimated glomerular filtration rate (eGFR). In contrast, age, triglyceride-glucose (TyG) index, hemoglobin A1c (HbA1c), male sex, smoking, and high-density lipoprotein cholesterol (HDL-C) demonstrated negative associations with ASCVD risk reduction.</p> Conclusion <p>Metabolic and bariatric surgery significantly reduced the 10-year ASCVD risk, with comparable outcomes between SG and OAGB. Key determinants influencing the 10-year ASCVD risk reduction included baseline risk score, age, TC, T2DM, TyG index, TG, HbA1c, SBP, sex, FPG, smoking, HDL-C, and eGFR.</p>

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Comparative Effectiveness of Sleeve Gastrectomy and One-Anastomosis Gastric Bypass on Cardiovascular Disease Risk: Insights from a Prospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年11月7日

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  • Sara Sadeghi,
  • Farhad Hosseinpanah,
  • Maryam Mahdavi,
  • Danial Molavizadeh,
  • Majid Valizadeh,
  • Alireza Khalaj,
  • Maryam Barzin

摘要

Aims

This study compares the effectiveness of sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) on the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk and identifies key factors influencing postoperative (post-op) changes in ASCVD risk.

Methods

This prospective cohort study assessed the 10-year ASCVD risk in patients undergoing SG or OAGB between 2013 and 2023 using the ACC/AHA ASCVD Risk Estimator. In addition to the baseline assessment, the risk score was evaluated at 6, 12, 24, 36, and 48 months post-op. Longitudinal analysis tracked changes in ASCVD risk, and regression models identified individual and combined factors influencing these changes.

Results

The analysis enrolled 1397 individuals (mean age 50.1 years, 87.9% female), including 952 SG and 445 OAGB participants. Following adjustments, the 10-year ASCVD risk significantly reduced post-op with no observed differences between the surgical groups. Positive associations with risk reduction were found for baseline risk, total cholesterol (TC), type 2 diabetes mellitus (T2DM), triglycerides (TG), systolic blood pressure (SBP), fasting plasma glucose (FPG), and estimated glomerular filtration rate (eGFR). In contrast, age, triglyceride-glucose (TyG) index, hemoglobin A1c (HbA1c), male sex, smoking, and high-density lipoprotein cholesterol (HDL-C) demonstrated negative associations with ASCVD risk reduction.

Conclusion

Metabolic and bariatric surgery significantly reduced the 10-year ASCVD risk, with comparable outcomes between SG and OAGB. Key determinants influencing the 10-year ASCVD risk reduction included baseline risk score, age, TC, T2DM, TyG index, TG, HbA1c, SBP, sex, FPG, smoking, HDL-C, and eGFR.