Metabolic-bariatric surgery reduced 10-year ASCVD risk similarly after sleeve gastrectomy and one-anastomosis gastric bypass over 4 years in 1397 patients.
Does sleeve gastrectomy compared to one-anastomosis gastric bypass improve predicted 10-year ASCVD risk in adults undergoing metabolic-bariatric surgery?
Metabolic-bariatric surgery significantly reduces predicted 10-year ASCVD risk, with comparable effectiveness between sleeve gastrectomy and one-anastomosis gastric bypass.
Absolute Event Rate: 0% vs 0%
Abstract Background Metabolic-bariatric surgery (MBS) is a transformative intervention that facilitates substantial and sustained weight loss while effectively ameliorating obesity-related comorbidities, particularly cardiovascular disease (CVD). Purpose This study aims to compare the effectiveness of sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) on the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Additionally, it seeks to identify key factors influencing post-operative (Post-Op) changes in ASCVD risk. Methods In this prospective observational cohort study, the 10-year ASCVD risk was estimated using the ACC/AHA ASCVD Risk Estimator at baseline, 6 months and 12 months Post-Op, and annually thereafter for up to 4 years. Participants aged 40-79 years who underwent MBS (SG or OAGB), between 2013 and 2023 were included. Longitudinal changes in ASCVD risk were analysed, and regression models were applied to evaluate the impact of individual and combined factors on risk changes over the maximum follow-up period. Results The study included 1397 participants (mean age 50.1 ± 7.2 years, 87.9% female), with 952 undergoing SG and 445 undergoing OAGB. Participants who underwent OAGB had a higher baseline body mass index (BMI) and more severe diabetes status. After adjusting for potential confounders, the 10-year ASCVD risk significantly reduced Post-Op, with no observed differences between the surgical groups over the 4-year follow-up period. Positive associations with ASCVD risk reduction were identified for baseline risk score, total cholesterol (TC), type 2 diabetes mellitus (T2DM), triglycerides, systolic blood pressure (SBP), fasting plasma glucose (FPG), and estimated glomerular filtration rate (eGFR). Conversely, age, triglyceride-glucose (TyG) index, haemoglobin A1c (HbA1c), male sex, smoking, and high-density lipoprotein cholesterol (HDL-C) demonstrated negative associations with ASCVD risk reduction. Conclusion(s) MBS significantly reduced the predicted 10-year ASCVD risk, with comparable outcomes between SG and OAGB. Key determinants influencing the changes in ASCVD risk included baseline risk score, age, TC, T2DM, TyG index, triglycerides, HbA1c, SBP, sex, FPG, smoking, HDL-C, and eGFR.
Sadeghi et al. (Sat,) reported a other. Metabolic-bariatric surgery reduced 10-year ASCVD risk similarly after sleeve gastrectomy and one-anastomosis gastric bypass over 4 years in 1397 patients.