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Promising data for cardiovascular outcomes of bariatric surgery in patients with obesity

Conference
DDW 2024
Bariatric surgery was compared with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with obesity. Primary endpoints included incident heart failure, composite cardiovascular events, and composite cerebrovascular events. The results favoured the bariatric surgery option.

A large-scale, retrospective study conducted between 1 January 2006, and 31 December 2022, included 6,790 adult patients with a BMI ≥35. Participants were divided into 2 cohorts: those who underwent bariatric surgery and those treated with GLP-1 RAs (dulaglutide, exenatide, liraglutide, semaglutide, albiglutide, and lixisenatide) for at least 2 years. The study utilised 1:1 propensity score matching to account for potential confounders, and several sensitivity analyses were performed to ensure the robustness of the findings.

The primary endpoints evaluated were the incidence of new-onset heart failure, composite cardiovascular events, and composite cerebrovascular events. The findings indicated that bariatric surgery was associated with a lower risk of adverse cardiovascular events than GLP-1 RA therapy. Specifically, the cumulative incidence of new-onset heart failure and cardiovascular events was lower in the bariatric surgery cohort at 2 years (RR 0.86; 95% CI 0.76–0.99 for heart failure, and RR 0.75; 95% CI 0.68–0.84 for cardiovascular events), at 4 years (RR 0.72; 95% CI 0.64–0.81 for heart failure, and RR 0.68; 95% CI 0.62–0.75 for cardiovascular events), and at 6 years of follow-up (RR 0.69; 95% CI 0.62–0.77 for heart failure, and RR 0.68; 95% CI 0.63–0.74 for cardiovascular events). While the cumulative incidence of cerebrovascular events was similar between the 2 cohorts at the 2-year mark, the bariatric surgery cohort exhibited a lower risk at 4 years (RR 0.72; 95% CI 0.62–0.84) and 6 years of follow-up (RR 0.72; 95% CI 0.63–0.83).

The study suggests that bariatric surgery is associated with a reduced risk of adverse cardiovascular events compared with GLP-1 RA therapy in patients with obesity, highlighting its potential cardiovascular benefits.

  1. Soban M, et al. Bariatric surgery versus glucagon-like peptide-1 receptor agonists: a comparison of cardiovascular outcomes. Sa1949, DDW 2024, 18–21 May, Washington, DC, USA.

Medical writing support was provided by Federica Angius.

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