Short-term cardiovascular events after bariatric surgery in patients with metabolic syndrome

Background: Patients with metabolic syndrome (MetS) are at increased risk of developing cardio-vascular disease along with other adverse events after bariatric surgery. Objectives: The incidence of short-term major adverse cardiovascular events (MACE) in patients with MetS undergoing bariatric surgery is not well characterized. Setting: Accredited bariatric surgery centers in the United States and Canada. Methods: A total of 760,076 patients aged >18 years with body mass index >35 kg/m(2) who under-went primary bariatric surgery between 2015 and 2018 were included. Patients with both diabetes and hypertension were described as the MetS cohort. Patient characteristics, operative technique, and 30-day outcomes were compared. The primary outcome was incidence of MACE, a composite of myocardial infarction, stroke, and all-cause mortality. Unadjusted and multivariable logistic regression analyses were performed and included an interaction between MetS and hyperlipidemia (HLD). Results: Of the 577,882 patients included, 111,128 (19.2%) exhibited MetS. Patients with MetS more frequently experienced MACE compared with patients without MetS (.3% versus .1%; P ,.001). The odds of MACE were greater for patients with MetS versus Non-MetS (odds ratio [OR] 2.87; 95% CI, 2.49-3.32) in the unadjusted analysis. MetS without HLD, MetS with HLD, and Non-MetS with HLD are significantly associated with MACE when compared with those with non-MetS without HLD. Conclusions: Patients with MetS have an increased frequency of cardiac events following bariatric surgery. Future studies should determine if optimization of 1 or more components of MetS or other related co-morbidities reduces the cardiovascular risk for patients. (Surg Obes Relat Dis 2024;20:18-28.) (c) 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.