This is translated to incidence rates of 3.96 and 5.10 events per 1,000 person-years, respectively. The difference was primarily attributed to a lower rate of heart attacks in the bypass group.
“This difference was primarily driven by lower rates of acute myocardial infarction,” the study authors wrote.
No statistically significant differences were found in rates of stroke, heart failure hospitalization, or all-cause mortality. The median follow-up duration was 5.1 years.
The median age of the patients was 42 years, and 73% were female. Most of them had severe obesity, with 60.7% having a body mass index of 40 or higher.
While gastric bypass was associated with fewer MACEs, the procedure also carried higher risks. Nearly 10% of patients required revision surgery, and more were hospitalized for dumping syndrome. Psychiatric hospitalizations were slightly more common in the bypass group. Conversely, the patients in the sleeve gastrectomy group had higher rates of reflux or ulcers and were more likely to require conversion to another surgical procedure.
Short-term safety outcomes showed low in-hospital mortality: 0.02% for gastric bypass and 0.07% for sleeve gastrectomy. Immediate complications were more common following a gastric bypass; however, 30-day readmission rates were similar between the groups.
Patients with recent heart attacks, strokes, end-stage kidney disease, or cancer were excluded to align with standard surgical criteria. All data were anonymized and obtained from Switzerland’s national inpatient database.
Advanced statistical methods were used to balance baseline characteristics and improve the reliability of comparisons. However, the investigators cautioned that, as an observational study, the findings didn't establish causation. Further research is needed to confirm long-term effects.
Still, the results provided new data on how different bariatric procedures may influence cardiovascular outcomes. The study authors concluded that “gastric bypass was associated with lower rates of MACE than sleeve gastrectomy” over the study period.
The authors reported no competing interests.
Source: JAMA Surgery