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April 18, 2012

Cardiovascular Events After Bariatric Surgery

Author Affiliations

Author Affiliation: Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano, Milan, Italy (antonio.pontiroli@unimi.it).

JAMA. 2012;307(15):1577-1578. doi:10.1001/jama.2012.483

To the Editor: The choice of surgical procedure for an obese patient should take into consideration the expected results in terms of the decrease in weight and comorbidities, the perioperative mortality, and the gain in life expectancy. In 2009, Buchwald et al1 showed a reduction in weight, comorbidities, and perioperative mortality with bariatric surgery; gastric banding showed the least benefit and biliopancreatic diversion showed the greatest benefit. In 2011, a meta-analysis showed a significant reduction in long-term mortality after gastric bypass and gastric banding and a greater effect of gastric bypass on cardiovascular mortality.2 Dr Sjöström and colleagues3 showed that bariatric surgery was associated with lower risk of cardiovascular events compared with nonsurgical treatment in patients with morbid obesity; this study did not analyze whether there were differences between different surgical procedures (ie, vertical banded gastroplasty, gastric banding, or gastric bypass).

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