Major Adverse Cardiac Events After Gastric Bypass vs Sleeve Gastrectomy

作者：Simone Wildisen, Rahel Laager, Tristan Struja, Alessia Wildisen, Beat Müeller, Philipp Schüetz, Ralph Peterli, Alexander Kutz · 发表于：JAMA Surgery · 年份：2025 · DOI：10.1001/jamasurg.2025.1065 · 被引用次数：13 · 研究领域：Bariatric Surgery and Outcomes、Cardiovascular Function and Risk Factors、Cardiac and Coronary Surgery Techniques

Importance: Metabolic bariatric surgery is the most effective and durable treatment for weight loss and improvement of cardiovascular diseases. With sleeve gastrectomy now surpassing gastric bypass as the most common procedure worldwide, comparing these procedures' associations with major adverse cardiac events (MACE) is needed. Objective: To compare the risk of MACE among individuals undergoing gastric bypass or sleeve gastrectomy. Design, Setting, and Participants: This population-based, inverse probability-weighted cohort study was conducted using administrative claims data from Switzerland among adults undergoing gastric bypass or sleeve gastrectomy for obesity treatment between January 2012 and December 2022. Inpatient individuals with a primary or secondary discharge procedure code for gastric bypass or sleeve gastrectomy were eligible for inclusion. Data were analyzed from April 2024 to September 2025. Exposure: Gastric bypass vs sleeve gastrectomy. Main Outcomes and Measures: A weighted cohort was analyzed to study the primary outcome of 4-point MACE, including acute myocardial infarction, ischemic stroke, hospitalizations for heart failure, and all-cause mortality. Secondary outcomes were the individual components of MACE, surgical reinterventions, and associated complications. Results: Of 39 067 patients, 30 270 patients (77.5%) underwent gastric bypass and 8798 patients (22.5%) underwent sleeve gastrectomy. Median (IQR) patient age was 42 (35-50) years, and 28 560 ...