Cardiovascular Risk After Bariatric Surgery for Obesity

John A. Batsis, Michael G. Sarr, Maria L. Collazo-Clavell, Randal J. Thomas, Abel Romero-Corral, Virend K. Somers, Francisco Lopez-Jimenez

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66 Scopus citations

Abstract

Obese patients have an increased prevalence of cardiovascular (CV) risk factors, which improve with bariatric surgery, but whether bariatric surgery reduces long-term CV events remains ill defined. A systematic review of published research was conducted, and CV risk models were applied in a validation cohort previously published. A standardized MEDLINE search using terms associated with obesity, bariatric surgery, and CV risk factors identified 6 test studies. The validation cohort consisted of a population-based, historical cohort of 197 patients who underwent Roux-en-Y gastric bypass and 163 control patients, identified through the Rochester Epidemiology Project. Framingham and Prospective Cardiovascular Munster Heart Study (PROCAM) risk scores were applied to calculate 10-year CV risk. In the validation cohort, absolute 10-year Framingham risk score for CV events was lower at follow-up in the bariatric surgery group (7.0% to 3.5%, p <0.001) compared with controls (7.1% to 6.5%, p = 0.13), with an intergroup absolute difference in risk reduction of 3% (p <0.001). PROCAM risk in the bariatric surgery group decreased from 4.1% to 2.0% (p <0.001), whereas the control group exhibited only a modest decrease (4.4% to 3.8%, p = 0.08). Using mean data from the validation study, the trend and directionality in risk was similar in the Roux-en-Y group. The test studies confirmed the directionality of CV risk, with estimated relative risk reductions for bariatric surgery patients ranging from 18% to 79% using the Framingham risk score compared with 8% to 62% using the PROCAM risk score. In conclusion, bariatric surgery predicts long-term decreases in CV risk in obese patients.

Original languageEnglish (US)
Pages (from-to)930-937
Number of pages8
JournalAmerican Journal of Cardiology
Volume102
Issue number7
DOIs
StatePublished - Oct 1 2008

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Batsis, J. A., Sarr, M. G., Collazo-Clavell, M. L., Thomas, R. J., Romero-Corral, A., Somers, V. K., & Lopez-Jimenez, F. (2008). Cardiovascular Risk After Bariatric Surgery for Obesity. American Journal of Cardiology, 102(7), 930-937. https://doi.org/10.1016/j.amjcard.2008.05.040