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.”
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