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Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis

AIMS: Obesity is a global health problem, associated with significant morbidity and mortality, often due to cardiovascular (CV) diseases. While bariatric surgery is increasingly performed in patients with obesity and reduces CV risk factors, its effect on CV disease is not established. We conducted...

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Autores principales: van Veldhuisen, Sophie L, Gorter, Thomas M, van Woerden, Gijs, de Boer, Rudolf A, Rienstra, Michiel, Hazebroek, Eric J, van Veldhuisen, Dirk J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123239/
https://www.ncbi.nlm.nih.gov/pubmed/35243488
http://dx.doi.org/10.1093/eurheartj/ehac071
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author van Veldhuisen, Sophie L
Gorter, Thomas M
van Woerden, Gijs
de Boer, Rudolf A
Rienstra, Michiel
Hazebroek, Eric J
van Veldhuisen, Dirk J
author_facet van Veldhuisen, Sophie L
Gorter, Thomas M
van Woerden, Gijs
de Boer, Rudolf A
Rienstra, Michiel
Hazebroek, Eric J
van Veldhuisen, Dirk J
author_sort van Veldhuisen, Sophie L
collection PubMed
description AIMS: Obesity is a global health problem, associated with significant morbidity and mortality, often due to cardiovascular (CV) diseases. While bariatric surgery is increasingly performed in patients with obesity and reduces CV risk factors, its effect on CV disease is not established. We conducted a systematic review and meta-analysis to evaluate the effect of bariatric surgery on CV outcomes, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. METHODS AND RESULTS: PubMed and Embase were searched for literature until August 2021 which compared bariatric surgery patients to non-surgical controls. Outcomes of interest were all-cause and CV mortality, atrial fibrillation (AF), heart failure (HF), myocardial infarction, and stroke. We included 39 studies, all prospective or retrospective cohort studies, but randomized outcome trials were not available. Bariatric surgery was associated with a beneficial effect on all-cause mortality [pooled hazard ratio (HR) of 0.55; 95% confidence interval (CI) 0.49–0.62, P < 0.001 vs. controls], and CV mortality (HR 0.59, 95% CI 0.47–0.73, P < 0.001). In addition, bariatric surgery was also associated with a reduced incidence of HF (HR 0.50, 95% CI 0.38–0.66, P < 0.001), myocardial infarction (HR 0.58, 95% CI 0.43–0.76, P < 0.001), and stroke (HR 0.64, 95% CI 0.53–0.77, P < 0.001), while its association with AF was not statistically significant (HR 0.82, 95% CI 0.64–1.06, P = 0.12). CONCLUSION: The present systematic review and meta-analysis suggests that bariatric surgery is associated with reduced all-cause and CV mortality, and lowered incidence of several CV diseases in patients with obesity. Bariatric surgery should therefore be considered in these patients.
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spelling pubmed-91232392022-05-23 Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis van Veldhuisen, Sophie L Gorter, Thomas M van Woerden, Gijs de Boer, Rudolf A Rienstra, Michiel Hazebroek, Eric J van Veldhuisen, Dirk J Eur Heart J Meta-Analysis AIMS: Obesity is a global health problem, associated with significant morbidity and mortality, often due to cardiovascular (CV) diseases. While bariatric surgery is increasingly performed in patients with obesity and reduces CV risk factors, its effect on CV disease is not established. We conducted a systematic review and meta-analysis to evaluate the effect of bariatric surgery on CV outcomes, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. METHODS AND RESULTS: PubMed and Embase were searched for literature until August 2021 which compared bariatric surgery patients to non-surgical controls. Outcomes of interest were all-cause and CV mortality, atrial fibrillation (AF), heart failure (HF), myocardial infarction, and stroke. We included 39 studies, all prospective or retrospective cohort studies, but randomized outcome trials were not available. Bariatric surgery was associated with a beneficial effect on all-cause mortality [pooled hazard ratio (HR) of 0.55; 95% confidence interval (CI) 0.49–0.62, P < 0.001 vs. controls], and CV mortality (HR 0.59, 95% CI 0.47–0.73, P < 0.001). In addition, bariatric surgery was also associated with a reduced incidence of HF (HR 0.50, 95% CI 0.38–0.66, P < 0.001), myocardial infarction (HR 0.58, 95% CI 0.43–0.76, P < 0.001), and stroke (HR 0.64, 95% CI 0.53–0.77, P < 0.001), while its association with AF was not statistically significant (HR 0.82, 95% CI 0.64–1.06, P = 0.12). CONCLUSION: The present systematic review and meta-analysis suggests that bariatric surgery is associated with reduced all-cause and CV mortality, and lowered incidence of several CV diseases in patients with obesity. Bariatric surgery should therefore be considered in these patients. Oxford University Press 2022-03-04 /pmc/articles/PMC9123239/ /pubmed/35243488 http://dx.doi.org/10.1093/eurheartj/ehac071 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Meta-Analysis
van Veldhuisen, Sophie L
Gorter, Thomas M
van Woerden, Gijs
de Boer, Rudolf A
Rienstra, Michiel
Hazebroek, Eric J
van Veldhuisen, Dirk J
Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
title Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
title_full Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
title_fullStr Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
title_full_unstemmed Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
title_short Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
title_sort bariatric surgery and cardiovascular disease: a systematic review and meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123239/
https://www.ncbi.nlm.nih.gov/pubmed/35243488
http://dx.doi.org/10.1093/eurheartj/ehac071
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