PDF(Pubmed)
Abstract：
Obesity is a major public health problem that is associated with serious comorbidities and premature mortality. Cardiovascular disease (CVD) is the major cause of morbidity and mortality associated with obesity. Lifestyle modifications, pharmacological therapy, and weight reduction surgery are the major interventions to date available for obesity management. Bariatric surgery has been increasingly utilized as a therapeutic option for obesity. In this meta-analysis, we aim to assess the effects of bariatric surgery on CVD outcomes and cardiovascular mortality. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. PubMed, Embase, Cochrane Library, Google Scholar, and Web of Science were searched until 03/01/2022. Our search included three types of bariatric surgery: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy, and gastric banding (GB). All were searched in conjunction with \"coronary artery disease,\" \"ischemic heart disease,\" \"myocardial infarction,\" \"cerebrovascular accident,\" \"stroke,\" \"atrial fibrillation,\" \"heart failure,\" \"arrhythmias,\" and \"mortality.\" We included 49 studies meeting the study criteria. Bariatric surgery showed a beneficial effect on coronary artery disease (CAD) (hazard ratio (HR) of 0.68 {95% confidence interval (CI): 0.52-0.91}, p = 0.008), myocardial infarction (MI) (HR of 0.53 {95% CI: 0.44-0.64}, p < 0.01) heart failure (HF) (HR of 0.45 {95% CI: 0.37-0.55}, p < 0.01), cerebrovascular accident (CVA) (HR of 0.68 {95% CI: 0.59-0.78}, p < 0.01), and cardiovascular mortality (HR of 0.48 {95% CI: 0.40-0.57}, p < 0.01). The effect on atrial fibrillation (AF) did not reach statistical significance: HR of 0.81 (95% CI: 0.65-1.01), p = 0.07. Our study, that is, an updated meta-analysis, including the three types of procedure, confirms beneficial effects on the major CVD outcomes, including coronary artery disease, myocardial infarction, cerebrovascular accident, and heart failure, and on CVD mortality. This study provides updated insights into the long-term CV effects of bariatric surgery, an increasingly common intervention for obesity.
摘要：
肥胖是一个主要的公共卫生问题，与严重的合并症和过早死亡有关。心血管疾病(CVD)是与肥胖相关的发病和死亡的主要原因。生活方式的修改，药物治疗,和减重手术是迄今为止可用于肥胖管理的主要干预措施.减肥手术已越来越多地用作肥胖症的治疗选择。在这个荟萃分析中，我们旨在评估减肥手术对CVD结局和心血管死亡率的影响.这项研究是根据系统评价和荟萃分析（PRISMA）清单的首选报告项目进行的。PubMed,Embase,科克伦图书馆,谷歌学者，和WebofScience一直搜索到2022年3月1日。我们的搜索包括三种类型的减肥手术：Roux-en-Y胃旁路术（RYGB），袖状胃切除术,和胃束带（GB）。所有这些都是结合“冠状动脉疾病”进行搜索的，缺血性心脏病,心肌梗塞,\"\"脑血管意外,\"\"笔画,\"\"心房颤动,心脏衰竭,“”心律失常，“和”死亡率。“我们纳入了符合研究标准的49项研究。减重手术对冠状动脉疾病（CAD）（风险比（HR）为0.68{95％置信区间（CI）：0.52-0.91}，p=0.008),心肌梗死（MI）（HR为0.53{95%CI：0.44-0.64}，p<0.01）心力衰竭（HF）（HR为0.45{95％CI：0.37-0.55}，p<0.01),脑血管意外（CVA）（HR为0.68{95%CI：0.59-0.78}，p<0.01),和心血管死亡率（HR为0.48{95%CI：0.40-0.57}，p<0.01)。对心房颤动（AF）的影响没有达到统计学意义：HR为0.81（95％CI：0.65-1.01），p=0.07。我们的研究,也就是说,更新的荟萃分析，包括三种类型的程序，证实了对主要心血管疾病结局的有益影响，包括冠状动脉疾病,心肌梗塞,脑血管意外,心力衰竭,和CVD死亡率。这项研究提供了有关减肥手术的长期CV效应的最新见解，越来越常见的肥胖干预措施。
