CAD Increases Post-Bariatric Surgery Risks

Patients with coronary artery disease (CAD) may be at an increased risk of 30-day postoperative mortality and major adverse cardiac events (MACEs) following bariatric surgery, according to the results of a recent study.

To examine the safety of bariatric surgery in this patient population, the researchers conducted a multicenter cohort study that included 167,819 participants. Of the total participants, there were 4172 patients with CAD and 163,647 without.

All participants were undergoing bariatric surgery within 1 of 832 accredited centers in the United States and Canada. The 2017 MBSAQIP database was used to collect participant data.

At the 30-day follow-up, the researchers observed that 172 patients (.10%) had died, 82 had had cardiac arrest (.05%), 57 had had a myocardial infarction (0.3%), and 135 had had a MACE (.08%).

The results also indicated that the endpoints were more significant in patients with CAD than those without CAD. Of the 4172 participants with CAD, 22 (.53%) had died, 13 (.31%) had had cardiac arrest, 17 (.41%) had had a myocardial infarction, and 28 (.67%) had had a MACE. Of the 167,819 participants without CAD, 150 (.09%) had died, 69 (.04%) had had cardiac arrest, 40 (.02%) had had a myocardial infarction, 107 (.07%) had had a MACE.

“Postoperative mortality and MACE following bariatric surgery are higher in patients with CAD than those without; however, the absolute incidence is low (<1%),” the researchers concluded. “The decision to pursue bariatric surgery and/or preoperative cardiac testing in patients with CAD should include consideration of the overall incidence of adverse cardiac outcomes and the stability of CAD.”

—Leigh Precopio

Reference:

Ruzieh M, Rogers AM, Banerjee K, et al. Safety of bariatric surgery in patients with coronary artery disease. Surg Obes Relat Dis. 2020;16(12):2031-2037. doi:10.1016/j.soard.2020.07.015