Can surgical weight loss reduce the risk of developing coronary heart disease?

Background: Coronary heart disease (CHD) accounts for one third of all deaths in people older than 35 years in the United States.

Objectives: The aim of this study is to determine the impact of bariatric surgery, especially laparoscopic sleeve gastrectomy, on the risk of developing CHD.

Setting: Academic, University affiliated hospital.

Methods: We retrospectively reviewed all patients who underwent bariatric surgery from 2010-2016. All patients between 30 and 74 years of age without a previous history of CHD were included in our study. The risk score for predicting the incidence of CHD was measured preoperatively and at 12 months of follow-up.

Results: Of the 1330 patients studied, 225 patients (16.9%) had all the required variables to calculate the CHD risk score. The mean age of our population was 51.4 ± 11.3 years, mostly female (67%, n = 152) and white (58.7%, n = 132). At the preoperative setting, our patient population had a systolic blood pressure in the prehypertensive ranges, with 40% (n = 90) having type 2 diabetes and 60% (n = 134) having arterial hypertension. The preoperative CHD preoperative risk was 8.9 ± 7.7% or 8-fold higher than the ideal risk. After 12 months of follow-up, the CHD absolute risk reduction was 2.7%, and the relative risk reduction was 42.0% for female patients and 5.4% and 38.8%, respectively, for male patients. All the metabolic factors used to calculate the risk of developing CHD had a significant improvement after 12 months.

Conclusions: Surgical weight loss reduces the risk of developing CHD. Further studies should assess these findings in a long-term follow-up.

Keywords: Coronary artery disease; Gastric bypass; Morbid obesity; Sleeve gastrectomy.