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Systematic Review

Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

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Department of General Surgery, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia
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Department of General Surgery, Dr. Soetomo General Hospital, Surabaya 60286, Indonesia
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Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia
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Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
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Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya 60115, Indonesia
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Department of Physiology and Pharmacology, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY 11203, USA
*
Authors to whom correspondence should be addressed.
Academic Editors: Milan Piya and Philip Mcternan
Nutrients 2021, 13(10), 3568; https://doi.org/10.3390/nu13103568
Received: 8 September 2021 / Revised: 6 October 2021 / Accepted: 10 October 2021 / Published: 12 October 2021
(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)
Cardiovascular diseases (CVDs) are the leading cause of death worldwide and obesity is a major risk factor that increases the morbidity and mortality of CVDs. Lifestyle modifications (e.g., diet control, physical exercise and behavioral changes) have been the first-line managements of obesity for decades. Nonetheless, when such interventions fail, pharmacotherapies and bariatric surgery are considered. Interestingly, a sudden weight loss (e.g., due to bariatric surgery) could also increase mortality. Thus, it remains unclear whether the bariatric surgery-associated weight reduction in patients with obesity and CVDs is beneficial for the reduction of Major Adverse Cardiovascular Events (MACE). Here, we performed a systematic literature search and meta-analysis of published studies comparing MACE in patients with obesity and CVDs who underwent bariatric surgery with control patients (no surgery). Eleven studies, with a total of 1,772,305 patients, which consisted of 74,042 patients who underwent any form of bariatric surgery and 1,698,263 patients with no surgery, were included in the systematic review. Next, the studies’ data, including odds ratio (OR) and adjusted hazard ratio (aHR), were pooled and analyzed in a meta-analysis using a random effect model. The meta-analysis of ten studies showed that the bariatric surgery group had significantly lower odds of MACE as compared to no surgery (OR = 0.49; 95% CI 0.40–0.60; p < 0.00001; I2 = 93%) and the adjustment to confounding variables in nine studies revealed consistent results (aHR = 0.57; 95% CI 0.49–0.66; p < 0.00001; I2 = 73%), suggesting the benefit of bariatric surgery in reducing the occurrence of MACE in patients with obesity and CVDs (PROSPERO ID: CRD42021274343). View Full-Text
Keywords: bariatric surgery; cardiovascular disease; obesity; major adverse cardiovascular events; meta-analysis; systematic review; risk factor; weight intervention bariatric surgery; cardiovascular disease; obesity; major adverse cardiovascular events; meta-analysis; systematic review; risk factor; weight intervention
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MDPI and ACS Style

Sutanto, A.; Wungu, C.D.K.; Susilo, H.; Sutanto, H. Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Nutrients 2021, 13, 3568. https://doi.org/10.3390/nu13103568

AMA Style

Sutanto A, Wungu CDK, Susilo H, Sutanto H. Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Nutrients. 2021; 13(10):3568. https://doi.org/10.3390/nu13103568

Chicago/Turabian Style

Sutanto, Andryanto, Citrawati D.K. Wungu, Hendri Susilo, and Henry Sutanto. 2021. "Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis" Nutrients 13, no. 10: 3568. https://doi.org/10.3390/nu13103568

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