Safety of Bariatric Surgery in Patients with Coronary Artery Disease

Abstract Introduction Patients with obesity and established coronary artery disease (CAD) may benefit from surgical weight loss; however, its safety is unknown in this population. Objective To assess the association between CAD and the incidence of 30-day postoperative mortality and major adverse cardiac events (MACE) in patients undergoing bariatric surgery. Settings Multicenter cohort study. Methods We used the 2017 MBSAQIP database to study patients undergoing bariatric surgery from accredited centers in the United States and Canada between Jan 1, 2017 and Dec 31, 2017. Multivariate logistic regression was used to determine whether established CAD, was independently associated with 30-day mortality and MACE, a composite endpoint that included myocardial infarction and/or cardiac arrest. Results We reviewed data from 167,819 patients from 832 centers. There were 4,172 patients with diagnosed CAD, and 163,647 without it. At 30 days follow up, the end points of mortality, cardiac arrest, myocardial infarction, and MACE occurred in 172 (0.10%), 82 (0.05%), and 57 (0.03%), and 135 (0.08%) patients, respectively. The end points occurred more significantly in patients with CAD compared to patients without CAD; 22 (0.53%) vs. 150 (0.09%) for mortality, 13 (0.31%) vs. 69 (0.04%) for cardiac arrest, 17 (0.41%) vs. 40 (0.02%) for myocardial infarction, and 28 (0.67%) vs. 107 (0.07%) for MACE (p Conclusion Postoperative mortality and MACE following bariatric surgery are higher in patients with CAD compared to those without; however, the absolute incidence is low (