Effectiveness of bariatric surgery in morbidly obese adults for cardiovascular outcomes: a systematic review

• Autores: Silva Licera, Humberto Rafael, Almeyda Yglesias, María Antoinette
• Formato: tesis de grado
• Fecha de Publicación: 2021
• Institución: Universidad Peruana de Ciencias Aplicadas
• Repositorio: UPC-Institucional
• Lenguaje: español
• OAI Identifier: oai:repositorioacademico.upc.edu.pe:10757/656005
• Enlace del recurso: http://hdl.handle.net/10757/656005
• Nivel de acceso: acceso abierto
• Materia: Bariatric surgery; Morbid obesity; Mortality; Cardiovascular diseases; Cirugía bariátrica; Obesidad mórbida; Mortalidad; Enfermedad cardiovascular; Diabetes Mellitus; http://purl.org/pe-repo/ocde/ford#3.00.00; https://purl.org/pe-repo/ocde/ford#3.02.00

Objectives: to determine the effectiveness of bariatric surgery to reduce the risk of cardiovascular events such as coronary heart disease, stroke, cardiovascular mortality, and total mortality in morbidly obese patients, compared with a non-surgical treatment and no intervention control group. Methods: a systematic review was carried out with cohort-type studies that evaluated, with a minimum follow-up of one year, morbidly obese adults who had undergone bariatric surgery compared to a control group of non-surgical treatment and without intervention in relation to the cardiovascular events such as coronary heart disease, stroke, cardiovascular mortality, and total mortality in morbidly obese patients. Results: 14 studies were selected that met our inclusion criteria. 44,912 patients who underwent bariatric surgery and 208,347 non-surgical controls were included. The high heterogeneity of the included studies did not allow the meta-analysis to be carried out. However, most of the individual results show decreased risk of the outcomes studied. A subgroup analysis was performed, where Bariatric Roux-en-Y surgery reduces the risk of coronary artery disease by approximately 60%. In morbidly obese diabetic patients, our calculations showed a risk reduction of 80% for cardiovascular mortality and 70% for total mortality. Finally, our calculations show a 58% decrease in cardiovascular mortality in studies with a follow-up of 2 or more years. Conclusions: Our study suggests that bariatric surgery is beneficial for morbidly obese adult patients at risk of presenting cardiovascular events.