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Lookup NU author(s): Dr Raheel Ahmed
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© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026.Background: Metabolic bariatric surgery (MBS) effectively lowers the risk of cardiovascular (CV) events in individuals with obesity, however, its application in those with pre-existing CV disease has been limited due to concerns about perioperative outcomes. Objective: This study evaluates the effectiveness and safety of bariatric surgery in reducing CV risk in people with pre-existing CV disease. Methods: We carried out an extensive search on PubMed, Google Scholar, Science Direct, and Clinicaltrial.gov from their inception until February 2025. Key outcomes included reductions in all-cause mortality (ACM), major adverse CV events (MACE), myocardial infarction (MI), and cerebrovascular events in people with and without prior CV disease undergoing bariatric surgery. Data were combined using a random-effects model and displayed as hazard ratios (HR) along with 95% confidence intervals (CI). Results: Three studies (n = 3,888) were included, with 1,523 patients getting Roux-en-Y gastric bypass and 442 receiving sleeve gastrectomy. Median age ranged from 52 to 56 years. Metabolic bariatric surgery was associated with a significant reduction in ACM (HR = 0.48, 95% CI: 0.38 to 0.61, p < 0.01) and MACE (HR = 0.55, 95% CI: 0.45 to 0.67, p < 0.01). However, no significant reduction was observed for MI (HR = 0.53, 95% CI: 0.24 to 1.18, p = 0.12) or cerebrovascular events (HR = 0.99, 95% CI: 0.64 to 1.54, p = 0.96). Conclusion: Metabolic bariatric surgery is associated with significantly lower ACM and MACE in people with obesity and prevalent CV disease. These results highlight the necessity for additional extensive trials to validate advantages in high-risk groups, specifically older individuals and those who have experienced prior MI or heart failure.
Author(s): Qazi SU, Shuja MH, Shakil F, Ansari HUH, Khan LA, Aziz AA, Dang AK, Hassan OU, Farhan M, Ahmed R, Hall ME
Publication type: Review
Publication status: Published
Journal: Obesity Surgery
Year: 2026
Pages: epub ahead of print
Online publication date: 07/04/2026
Acceptance date: 22/03/2026
ISSN (print): 0960-8923
ISSN (electronic): 1708-0428
Publisher: Springer
URL: https://doi.org/10.1007/s11695-026-08634-0
DOI: 10.1007/s11695-026-08634-0
PubMed id: 41944992
