Heart Failures Post Bariatric Surgery #SurgicalPioneering #rezalankarani

Ajouté : 2026-05-24

[00:00:00]This population-based retrospective cohort study compared major adverse cardiac events MACE between gastric bypass GB and sleeve gasterectomy SG in 39,67 Swiss patients 2012 to 2022.

[00:00:16]Key findings include a GB demonstrated a 25% lower risk of major adverse cardiac events. MACE defined as acute mocardial inffection MI eskeemic stroke heart failure hospitalization or all cause mortality compared to SG HR 0.75 95% CI 0.64 to 0.88.

[00:00:39]This was driven primarily by a 40% reduction in MI risk HR 0.60. 60 a safety trade-offs GB was associated with higher rates of short-term complications eg anesmotic leaks dumping syndrome and reoperations while SG had higher risks of gastroosophageal reflux disease gird and conversion surgeries due to suboptimal outcomes asterisk no differences were observed in eskeemic stroke heart failure or mortality strengths of the study large sample size with nearly 40,000 patients this is one of the largest comparative Studies in beriatric surgery enhancing statistical power and generalizability are long-term follow-up median 5.1 years up to 11 years allowed detection of delayed cardiovascular benefits of GB which diverged after tilda 2.5 years a critical observation absent in shorter trials. Advanced statistical adjustments inverse probability waiting IPW minimized confounding by balancing baseline characteristics eg coorbidities addressing biases common in observational studies are included all cause mortality and a four component mace composite aligning with regulatory standards for cardiovascular trials are evaluated both short-term eg in hospital complications and long-term eg psychiatric hospitalizations outcomes providing a holistic view of risks and benefits reflects contemporary practice patterns as SG has surpassed GB globally. Our findings inform clinical decision-making by highlighting trade-offs between cardiovascular benefits and procedural risks.