Background

Metabolic bariatric surgery (MBS) is recognized for its positive impact on cardiovascular risk profiles. Previous studies have underscored its association with a decreased risk of future coronary revascularization (CR), percutaneous coronary revascularization (PCI) and coronary artery bypass grafting (CABG). However, there is limited data on the impact of MBS on CR morbidity outcomes.ObjectivesThis study aims to assess the impact of MBS on the rate of major adverse cardiovascular events (MACE), including in-hospital death, stroke, and myocardial infarction (MI) following CR.

Methods

Retrospective analysis utilizing the Statewide Planning and Research Cooperative System (SPARCS) database was conducted on patients who underwent CR between 2009 and 2018. Patients were divided into those with previous MBS and those without. To mitigate baseline differences between surgical and non-surgical groups, propensity score matching was employed. Non-surgical records were matched with surgical records in a 10:1 ratio without replacement to minimize systematic disparities.

Results

The propensity matched study encompassed 2,959 patients, including 273 (9.23%) MBS patients and 2,686 (90.77%) non-MBS patients. Of the total patient population, 46.91% were male, 78.44% were white non-hispanic, and 67.59% were commercially insured. Additionally, 75.77% had hypertension, 7.27% had renal failure, and 51.44% had diabetes. The cumulative incidence of MACE following CR was similar between the two groups (figure).

Conclusions

Although MBS has been previously associated with reduced risk of future CR, the current data suggests no significant difference in the incidence of MACE after CR for patients with previous MBS compared to non-BMS.