The Impact of Metabolic Bariatric Surgery on Cardiovascular Diseases in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

Ali Esparham; Saeed Shoar; Ali Mehri; Zhamak Khorgami; Venkat R Modukuru

doi:10.1007/s11695-024-07238-w

The Impact of Metabolic Bariatric Surgery on Cardiovascular Diseases in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

Obes Surg. 2024 Apr 25. doi: 10.1007/s11695-024-07238-w. Online ahead of print.

Authors

Ali Esparham¹, Saeed Shoar², Ali Mehri³, Zhamak Khorgami^{4

5}, Venkat R Modukuru⁶

Affiliations

¹ Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Aliesp0532@gmail.com.
² Department of Clinical Research, Scientific Writing Corp, Houston, TX, USA.
³ Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
⁴ Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
⁵ Department of Surgery, School of Community Medicine, University of Oklahoma, Tulsa, OK, USA.
⁶ Bariatric and Metabolic Surgery Program, Newark Beth Israel Medical Center, RWJ Barnabas Health, Rutgers NJ Medical School, Newark, NJ, USA.

PMID: 38662250
DOI: 10.1007/s11695-024-07238-w

Abstract

Purpose: There is a strong association between metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity which are both important risk factors for cardiovascular diseases (CVDs). The current study aimed to assess the association of MBS with different CVDs in patients with MASLD.

Materials and methods: The National Inpatient Sample (NIS) database from 2016 to 2020 were analyzed by using ICD-10 codes. A propensity score matching in a 1:1 ratio was done to match the MBS and non-MBS groups.

Results: After weighted analysis, 1,124,155 and 68,215 patients were included in non-MBS and MBS groups, respectively. MBS was associated with significantly lower risk of hospitalization for coronary artery disease (OR 0.633 (0.569-0.703), p value < 0.001), acute myocardial infarction (OR 0.606 (0.523-0.701), p value < 0.001), percutaneous coronary intervention (OR 0.578 (0.489-0.682), p value < 0.001), and thrombolysis (OR 0.765 (0.589-0.993), p value = 0.044) compared to the non-MBS group in patients with MASLD. Furthermore, MBS was associated with 52% reduced risk of hospitalization for hemorrhagic stroke in patients with MASLD (OR 0.481, 95% CI 0.337-0.686, p value < 0.001). However, ischemic stroke was not significant between the two groups (OR 1.108 (0.905-1.356), p value = 0.322). In addition, MBS was associated with 63% and 60% reduced risk of hospitalization for heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) in patients with MASLD (OR 0.373, 95% CI 0.300-0.465 and OR 0.405, 95% CI 0.325-0.504, p value < 0.001 for both), respectively.

Conclusion: The current study showed that MBS is significantly associated with a reduced risk of hospitalization for CVD in patients with MASLD.

Keywords: Bariatric surgery; Cardiovascular disease; Coronary artery disease; Heart failure; MASLD; Metabolic dysfunction–associated steatotic liver disease; Nonalcoholic fatty liver disease.