Gastric Bypass Lowers Heart Attack Risk More Than Sleeve Surgery, Long-Term Study Finds.
Gastric Bypass Lowers Heart Attack Risk More Than Sleeve Surgery, Long-Term Study Finds.
2. 1. Study Overview:
A long-term study published in JAMA Surgery (May 12, 2025) compared outcomes between gastric bypass surgery and sleeve gastrectomy in over 39,000 adult patients.
2. Key Finding:
Gastric bypass was linked to a significantly lower risk of major cardiovascular events—including myocardial infarction, stroke, heart failure, and all-cause mortality—compared to sleeve gastrectomy (1.9% vs. 3.0%).
3. Primary Driver:
The reduced rate of heart attacks (MI) was the main contributor to the cardiovascular benefit seen with gastric bypass.
4. Other Benefits of Gastric Bypass:
• Lower risk of conversion surgery (secondary operations to adjust or replace the initial procedure).
• Lower incidence of peptic ulcer disease.
5. Downsides of Gastric Bypass:
• Higher likelihood of needing revision surgery due to its more complex nature.
• After adjustment, it was associated with a higher risk of in-hospital complications, though mortality rates remained similar to sleeve gastrectomy.
6. Context & Interpretation:
• Although sleeve gastrectomy has been more popular recently due to its safety profile and shorter surgical time, concerns are rising over long-term weight regain and new-onset GERD, which may explain the shift back toward bypass.
• Authors emphasize the need for individualized patient selection and shared decision-making in clinical practice.
7. Expert Commentary:
• Metabolic bariatric surgery remains the most effective long-term treatment for severe obesity despite the emergence of GLP-1–based medications, which still face limitations in sustainability and adherence.
Source:
