The long-term risk of cardiovascular events in patients following bariatric surgery compared to a non-surgical population with obesity and the general population: a comprehensive national cohort study.

purposeThis study evaluated the differences in long-term cardiovascular events between obese patients who received bariatric surgery (BS), those who did not, and the general population (GP).

methodsBetween 2003 and 2008, patients with severe obesity, aged 18-55 years, were divided into the non-surgical (NS) and BS groups and were included in this retrospective study. We also extracted data of healthy civilians defined as the GP. The incidence of cardiovascular events, including myocardial infarction, intracranial hemorrhage, epidural hemorrhage, ischemic stroke, and transient ischemic attack, was defined as the primary end point. Patients were followed up either until the end of 2013, upon reaching the primary end point, or death.

resultsAfter propensity score matching, 1436 patients were included in both the BS and NS groups, and 4829 subjects were enrolled as the GP. Of these, 57 (3.9%), 10 (0.6%), and 30 (0.62%) subjects in the NS, BS, and GP, respectively, experienced cardiovascular events. Multivariate analysis revealed that patients with BS had a significantly lower risk of cardiovascular events (HR = 0.168; 95% CI 0.085-0.328; p < 0.001) than those in the NS group, but it was not significantly different in the BS group compared with the GP (HR = 1.202; 95% CI 0.585-2.471; p = 0.617).

conclusionLong-term risk of cardiovascular events was significantly lower among patients who had BS, compared to the NS obese patients. Thus, the long-term cardiovascular risk between those who received BS and the GP had no significant difference, in a retrospective view.