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

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.

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Abbreviations

ASCVD:

Atherosclerotic cardiovascular disease

BMI:

Body mass index

CAC:

Coronary artery calcium score

EWL:

Excess body weight loss

FRS:

Framingham risk score

HDL-C:

High-density lipoprotein cholesterol

IMT:

Carotid intima-media thickness

LDL-C:

Low-density lipoprotein cholesterol

MAPSE:

Mitral annular plane systolic excursion

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

T2DM:

Type 2 diabetes mellitus

TAPSE:

Tricuspid annular plane systolic excursion

TWL:

Total weight loss

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Correspondence to Miguel F. Herrera.

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Ponce de León-Ballesteros, G., Sánchez-Aguilar, H., Aguilar-Salinas, C.A. et al. Improvement of the 10-Year Atherosclerotic Cardiovascular Disease (ASCVD) Risk Following Bariatric Surgery. OBES SURG 30, 3997–4003 (2020). https://doi.org/10.1007/s11695-020-04770-3

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Keywords

  • Cardiovascular risk
  • Bariatric surgery
  • Total cholesterol
  • Systolic blood pressure
  • Roux-Y gastric bypass
  • Sleeve gastrectomy