Scholarlink

Background <p>Metabolic bariatric surgery (MBS) effectively lowers the risk of cardiovascular (CV) events in individuals with obesity, however, its application in those with pre-existing CV disease has been limited due to concerns about perioperative outcomes.</p> Objective <p>This study evaluates the effectiveness and safety of bariatric surgery in reducing CV risk in people with pre-existing CV disease.</p> Methods <p>We carried out an extensive search on PubMed, Google Scholar, Science Direct, and Clinicaltrial.gov from their inception until February 2025. Key outcomes included reductions in all-cause mortality (ACM), major adverse CV events (MACE), myocardial infarction (MI), and cerebrovascular events in people with and without prior CV disease undergoing bariatric surgery. Data were combined using a random-effects model and displayed as hazard ratios (HR) along with 95% confidence intervals (CI).</p> Results <p>Three studies (<i>n</i> = 3,888) were included, with 1,523 patients getting Roux-en-Y gastric bypass and 442 receiving sleeve gastrectomy. Median age ranged from 52 to 56 years. Metabolic bariatric surgery was associated with a significant reduction in ACM (HR = 0.48, 95% CI: 0.38 to 0.61, <i>p</i> &lt; 0.01) and MACE (HR = 0.55, 95% CI: 0.45 to 0.67, <i>p</i> &lt; 0.01). However, no significant reduction was observed for MI (HR = 0.53, 95% CI: 0.24 to 1.18, <i>p</i> = 0.12) or cerebrovascular events (HR = 0.99, 95% CI: 0.64 to 1.54, <i>p</i> = 0.96).</p> Conclusion <p>Metabolic bariatric surgery is associated with significantly lower ACM and MACE in people with obesity and prevalent CV disease. These results highlight the necessity for additional extensive trials to validate advantages in high-risk groups, specifically older individuals and those who have experienced prior MI or heart failure.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effect of Metabolic Bariatric Surgery on Cardiovascular Outcomes in People with Obesity and Pre-existing Cardiovascular Disease: A Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年4月7日

查看全文
  • Shurjeel Uddin Qazi,
  • Muhammad Hamza Shuja,
  • Firzah Shakil,
  • Huzaifa Ul Haq Ansari,
  • Laiba Arshad Khan,
  • Ahmed Ali Aziz,
  • Ashujot K. Dang,
  • Omer Ul Hassan,
  • Muzzamil Farhan,
  • Raheel Ahmed,
  • Michael E. Hall

摘要

Background

Metabolic bariatric surgery (MBS) effectively lowers the risk of cardiovascular (CV) events in individuals with obesity, however, its application in those with pre-existing CV disease has been limited due to concerns about perioperative outcomes.

Objective

This study evaluates the effectiveness and safety of bariatric surgery in reducing CV risk in people with pre-existing CV disease.

Methods

We carried out an extensive search on PubMed, Google Scholar, Science Direct, and Clinicaltrial.gov from their inception until February 2025. Key outcomes included reductions in all-cause mortality (ACM), major adverse CV events (MACE), myocardial infarction (MI), and cerebrovascular events in people with and without prior CV disease undergoing bariatric surgery. Data were combined using a random-effects model and displayed as hazard ratios (HR) along with 95% confidence intervals (CI).

Results

Three studies (n = 3,888) were included, with 1,523 patients getting Roux-en-Y gastric bypass and 442 receiving sleeve gastrectomy. Median age ranged from 52 to 56 years. Metabolic bariatric surgery was associated with a significant reduction in ACM (HR = 0.48, 95% CI: 0.38 to 0.61, p < 0.01) and MACE (HR = 0.55, 95% CI: 0.45 to 0.67, p < 0.01). However, no significant reduction was observed for MI (HR = 0.53, 95% CI: 0.24 to 1.18, p = 0.12) or cerebrovascular events (HR = 0.99, 95% CI: 0.64 to 1.54, p = 0.96).

Conclusion

Metabolic bariatric surgery is associated with significantly lower ACM and MACE in people with obesity and prevalent CV disease. These results highlight the necessity for additional extensive trials to validate advantages in high-risk groups, specifically older individuals and those who have experienced prior MI or heart failure.

Graphical Abstract