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The long-term risk of cardiovascular events in patients following bariatric surgery compared to a non-surgical population with obesity and the general population: a comprehensive national cohort study

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Abstract

Purpose

This study evaluated the differences in long-term cardiovascular events between obese patients who received bariatric surgery (BS), those who did not, and the general population (GP).

Methods

Between 2003 and 2008, patients with severe obesity, aged 18–55 years, were divided into the non-surgical (NS) and BS groups and were included in this retrospective study. We also extracted data of healthy civilians defined as the GP. The incidence of cardiovascular events, including myocardial infarction, intracranial hemorrhage, epidural hemorrhage, ischemic stroke, and transient ischemic attack, was defined as the primary end point. Patients were followed up either until the end of 2013, upon reaching the primary end point, or death.

Results

After propensity score matching, 1436 patients were included in both the BS and NS groups, and 4829 subjects were enrolled as the GP. Of these, 57 (3.9%), 10 (0.6%), and 30 (0.62%) subjects in the NS, BS, and GP, respectively, experienced cardiovascular events. Multivariate analysis revealed that patients with BS had a significantly lower risk of cardiovascular events (HR = 0.168; 95% CI 0.085–0.328; p < 0.001) than those in the NS group, but it was not significantly different in the BS group compared with the GP (HR = 1.202; 95% CI 0.585–2.471; p = 0.617).

Conclusion

Long-term risk of cardiovascular events was significantly lower among patients who had BS, compared to the NS obese patients. Thus, the long-term cardiovascular risk between those who received BS and the GP had no significant difference, in a retrospective view.

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Data availability

The data utilized in this study cannot be made available in the manuscript, in the supplemental files, or in a public repository due to the “Personal Information Protection Act” executed by Taiwan’s government, starting from 2012. Requests for data can be sent as a formal proposal to the NHIRD (http://nhird.nhri.org.tw) or by email to nhird@nhri.org.tw.

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Acknowledgments

This study is based in part on data from the National Health Insurance Research Database (NHIRD), provided by the National Health Insurance Administration, Ministry of Health and Welfare, and managed by the National Health Research Institutes (registered number NHIRD-103-246).

Funding

This work was supported by the E-Da Hospital Research Foundation (EDAHP-107-011, EDAHI-109-001) and by the Buddhist Dalin Tzu Chi Hospital Research Foundation (DTCRD108-I-13).

Author information

Author notes

  1. Cheng-Hung Lee contributed equally to this work.

Authors and Affiliations

  1. Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan

    Shao-Lun Hung, Chung-Yen Chen, Wei-Leng Chin & Jian-Han Chen

  2. Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan

    Shao-Lun Hung, Chung-Yen Chen & Jian-Han Chen

  3. Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan

    Wei-Leng Chin

  4. Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, Chia-Yi, Taiwan

    Cheng-Hung Lee

  5. School of Medicine, Tzu Chi University, Hualien, Taiwan

    Cheng-Hung Lee

  6. School of Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan

    Jian-Han Chen

  7. Department of General Surgery, E-Da Hospital, No. 1, Yida Rd., Yanchao Dist., Kaohsiung City, 824, Taiwan (Republic of China)

    Jian-Han Chen

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  1. Shao-Lun Hung
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Correspondence to Jian-Han Chen.

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Hung, SL., Chen, CY., Chin, WL. et al. The long-term risk of cardiovascular events in patients following bariatric surgery compared to a non-surgical population with obesity and the general population: a comprehensive national cohort study. Langenbecks Arch Surg 406, 189–196 (2021). https://doi.org/10.1007/s00423-020-02027-2

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  • DOI: https://doi.org/10.1007/s00423-020-02027-2

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