Improvement of the 10-Year Atherosclerotic Cardiovascular Disease (ASCVD) Risk Following Bariatric Surgery

Obes Surg. 2020 Oct;30(10):3997-4003. doi: 10.1007/s11695-020-04770-3. Epub 2020 Jun 17.

Abstract

Background: Several studies have shown improvement in cardiometabolic risk factors, as well as in the related mortality following bariatric surgery. However, few studies have assessed changes in the estimated cardiovascular risk.

Objective: The aim of the present study was to investigate the effect of bariatric surgery on the estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk.

Patients and methods: We performed a retrospective analysis from a prospectively maintained database of patients who underwent a primary bariatric procedure from 2004 to 2018. The 10-year ASCVD risk was estimated before and after 1 year of surgery using the ASCVD Risk Estimator Plus of the American College of Cardiology. Changes in the ASCVD risk were evaluated.

Results: There were 58 (51.3%) women and 55 (48.7%) men with a mean age of 49.9 years. Before surgery, 64 patients had arterial hypertension, 57 T2DM, and 49 were smokers. Baseline mean estimated 10-year ASCVD risk was 8.50 ± 7.92%. Fifty-one (45.1%), 10 (8.8%), 41 (36.3%), and 11 (9.7%) patients were classified as low, borderline, intermediate, and high risk, respectively. One year after surgery, 92.9% of the patients showed a reduction of the estimated 10-year ASCVD risk. Mean values were significantly lower (5.31 ± 5.95%) when compared to basal ones (p < 0.0001). According to the risk classification, 71 (62.8%), 13 (11.5%), 26 (23%), and 3 (2.7%) were cataloged as low, borderline, intermediate, and high risk, respectively.

Conclusions: Surgically induced weight loss leads to a significant improvement in the estimated 10-year ASCVD risk, 1 year after surgery.

Keywords: Bariatric surgery; Cardiovascular risk; Roux-Y gastric bypass; Sleeve gastrectomy; Systolic blood pressure; Total cholesterol.

MeSH terms

  • Bariatric Surgery*
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Female
  • Gastrectomy
  • Gastric Bypass*
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid* / surgery
  • Retrospective Studies