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Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity
Open accessAbstract
IMPORTANCE: Although metabolic surgery (defined as procedures that influence metabolism by inducing weight loss and altering gastrointestinal physiology) significantly improves cardiometabolic risk factors, the effect on cardiovascular outcomes has been less well characterized. OBJECTIVE: To investigate the relationship between metabolic surgery and incident major adverse cardiovascular events (MACE) in patients with type 2 diabetes and obesity. DESIGN, SETTING, AND PARTICIPANTS: Of 287 438 adult patients with diabetes in the Cleveland Clinic Health System in the United States between 1998 and 2017, 2287 patients underwent metabolic surgery. In this retrospective cohort study, these patients were matched 1:5 to nonsurgical patients with diabetes and obesity (body mass index [BMI] ≥30), resulting in 11 435 control patients, with follow-up through December 2018. EXPOSURES: Metabolic gastrointestinal surgical procedures vs usual care for type 2 diabetes and obesity. MAIN OUTCOMES AND MEASURES: The primary outcome was the incidence of extended MACE (composite of 6 outcomes), defined as first occurrence of all-cause mortality, coronary artery events, cerebrovascular events, heart failure, nephropathy, and atrial fibrillation. Secondary end points included 3-component MACE (myocardial infarction, ischemic stroke, and mortality) and the 6 individual components of the primary end point. RESULTS: Among the 13 722 study participants, the distribution of baseline covariates was balanced between the surgical group and the nonsurgical group, including female sex (65.5% vs 64.2%), median age (52.5 vs 54.8 years), BMI (45.1 vs 42.6), and glycated hemoglobin level (7.1% vs 7.1%). The overall median follow-up duration was 3.9 years (interquartile range, 1.9-6.1 years). At the end of the study period, 385 patients in the surgical group and 3243 patients in the nonsurgical group experienced a primary end point (cumulative incidence at 8-years, 30.8% [95% CI, 27.6%-34.0%] in the surgical group and 47.7% [95% CI, 46.1%-49.2%] in the nonsurgical group [P < .001]; absolute 8-year risk difference [ARD], 16.9% [95% CI, 13.1%-20.4%]; adjusted hazard ratio [HR], 0.61 [95% CI, 0.55-0.69]). All 7 prespecified secondary outcomes showed statistically significant differences in favor of metabolic surgery, including mortality. All-cause mortality occurred in 112 patients in the metabolic surgery group and 1111 patients in the nonsurgical group (cumulative incidence at 8 years, 10.0% [95% CI, 7.8%-12.2%] and 17.8% [95% CI, 16.6%-19.0%]; ARD, 7.8% [95% CI, 5.1%-10.2%]; adjusted HR, 0.59 [95% CI, 0.48-0.72]). CONCLUSIONS AND RELEVANCE: Among patients with type 2 diabetes and obesity, metabolic surgery, compared with nonsurgical management, was associated with a significantly lower risk of incident MACE. The findings from this observational study must be confirmed in randomized clinical trials. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03955952.
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“After surgery, the significant improvement of metabolic disease, as well as the decrease in overall mortality, has been reported in multiple studies further supporting the importance of this treatment modality [15–19].”
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“After surgery, the significant improvement of metabolic disease, as well as the decrease in overall mortality, has been reported in multiple studies further supporting the importance of this treatment modality [15–19].”
In the citing paper
“Indeed, marked weight loss achieved through bariatric surgery is associated with improvements in glucose levels and cardiac structure and function in patients with obesity and T2DM.14, 15, 16”
From The cardioprotective effects of semaglutide exceed those of dietary weight loss in mice with HFpEF (2023) · cites this paper as [14]
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“In a recently published retrospective cohort study, a substantial reduction in all-cause mortality and incident cases of major adverse cardiovascular events such as coronary artery events, cerebrovascular events, nephropathy, heart failure and atrial fibrillation was noted in those who had bariatric surgery [62].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [62]
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Self-citationAfter 70 Years, Metabolic Surgery Has Earned a Cardiovascular Outcome Trial
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“studies with longer follow-up have shown additional benefits including increased survival and reduced incidence of major adverse cardiovascular endpoints and cancer.(3,7-9) However, because of the nonrandomized design of these large studies, all are potentially subject to methodological limitations including residual…”
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“Morbid obesity, characterized as having a body mass index (BMI) of over 40 kg/m(2), is a major risk factor for cardiovascular diseases [1], arterial hypertension, sleep apnea, and type 2 diabetes mellitus [2, 3].”
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“Pathological cardiac metabolic shifts are found in an array of clinical contexts, including familial monogenic cardiomyopathies and lifestyle-associated cardiometabolic disease (Aminian et al, 2019; Shah et al, 2020).”
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Perceived Benefits of Bariatric Surgery: Patient Perspectives
Alsaqaaby, M. S., Alabduljabbar, K. A., Alruwaili, H., Neff, K., Heneghan, H., Pournaras, D. J., & le Roux, C. W. (2024) · Obesity Surgery · doi:10.1007/s11695-023-07030-2 · Cited by 7
“The second-most important perceived benefit of bariatric surgery was the reduction in heart disease, another well-documented advantage of bariatric surgery [20, 21].”
Estimating the Effect of Bariatric Surgery on Cardiovascular Events Using Observational Data?
Madenci, A. L., Kurgansky, K. E., Dickerman, B. A., Gerlovin, H., Wanis, K. N., Smith, A. D., Trinquart, L., GAGNON, D. R., Cho, K., Gaziano, J. M., et al. (2024) · Epidemiology · doi:10.1097/ede.0000000000001765 · Cited by 7
“…presurgery interventions and lifestyle modifications on cardiovascular risk (or, stated another way, inadequate adjustment for covariate history), 2,3 and initiation of follow-up time at the time of surgery with imbalances in confounder history (e.g., trajectory of laboratory tests and vital signs…”
Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients With Heart Failure
Kachmar, M., Corpodean, F., LaChute, C., Popiv, I., Cook, M. W., Danos, D., Albaugh, V. L., Moraes, D. L., Tang, W. H. W., & Schauer, P. R. (2024) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2024.07.012 · Cited by 7
Self-citationEffect of Bariatric Surgery on Serum Enzyme Status in Obese Patients
Guan, B.-S., Chen, Y.-Y., Chong, T.-H., Peng, J.-Z., Mak, T.-K., Wang, C.-C., & Yang, J.-G. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04554-9 · Cited by 7
“Elevated LDH level was seen some clinical diseases (such as myocardial ischemia and hypothyroidism), and it was reported that bariatric surgery had a favorable effect on myocardial ischemia and hypothyroidism [27, 28].”
BackgroundShinagawa, A., Ahrendt, A. J., Epstein, E. M., Lambin, J.-H., Lambin, R., Cox, M., Gevorkian, J., Shoenberger, D., & Sasse, K. C. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04779-8 · Cited by 7
Medical and Surgical Obesity Treatments and Atherosclerosis: Mechanisms beyond Typical Risk Factors
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Cardiorenal outcomes in eligible patients referred for bariatric surgery
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“As bariatric surgery has been shown to reduce CVD in patients with T2D (8), and the majority of patients undergoing bariatric surgery do not have T2D, we undertook additional analyses of primary and secondary CVD outcomes in those with and without T2D.”
InfluentialCogollo, V. J., Valera, R. J., Fonnegra, C. B., Sarmiento-Cobos, M. F., Montorfano, L. M., Bordes, S. J., Rivera, C. E., Liang, H., Menzo, E. L., Szomstein, S., et al. (2022) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2022.04.013 · Cited by 7
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Wilson, R. L., & Aminian, A. (2023) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2023.01.027 · Cited by 7
Self-citationThe role of weight control in the management of type 2 diabetes mellitus: Bariatric surgery
Xu, T. Q., & Kindel, T. L. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110667 · Cited by 7
Weight loss maintenance after bariatric surgery
Cho, Y. H., Lee, Y., Choi, J. I., Lee, S. R., & Lee, S. Y. (2023) · World Journal of Clinical Cases · doi:10.12998/wjcc.v11.i18.4241 · Cited by 11
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“We also generated E-values to assess the sensitivity to unmeasured confounding [34].”
MethodStrizheletsky, V. V., Gomon, Y. М., Spichakova, E. A., Колбин, А. С., Makarov, S. А., Lomiya, A. B., Sultanova, F. М., & Budanov, D. S. (2023) · Endoscopic Surgery · doi:10.17116/endoskop2023290315 · Cited by 6
Barajas-Gamboa, J. S., Restrepo-Rodas, G., Mocanu, V., Shin, T. H., Romero-Vélez, G., Strong, A. T., Navarrete, S., Rodriguez, J., Corcelles, R., Kroh, M., et al. (2025) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2025.04.002 · Cited by 6
Lin, Y., Kao, C., Hung, K., Yu, T., Liu, M., Lai, C.-C., & Wu, J. (2025) · Obesity Surgery · doi:10.1007/s11695-025-07939-w · Cited by 6
“[24] Overall, the literature consistently supports that BMS confers significant cardioprotection by reducing coronary events and strokes while improving survival, aligning with our observed trend of reduced MACE and all-cause mortality in the surgical cohort.”
InfluentialMortality After Bariatric Surgery: A Comprehensive Review
Jumaev, N. A., Teshaev, O., Tavasharov, B., & Lekomseva, M. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08212-w · Cited by 10
“Moreover, metabolic and bariatric surgery provides substantial improvements in obesity-related comorbidities, particularly type 2 diabetes, hypertension, dyslipidemia, and obstructive sleep apnea [5].”
Manyari, Á. A. O., Alvarez, A. L. A., Manyari, J. D. O., Gonzalez, F., & Pouwels, S. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08414-2 · Cited by 9
Cordova, F., & Malaga, N. C. (2025) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2025.11.024 · Cited by 9
The evolving role of metabolic and bariatric surgery in contemporary clinical practice
Panichella, G., Gentile, F., Nannipieri, M., & Emdin, M. (2025) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwaf787 · Cited by 6
Gam, S., Petz, A., Bjerre, L. R., Bøgild, J., Nielsen, A. B., Sørensen, R. N., Kolind, M. I., Gram, B., Hansen, S. G., & Aagaard, P. (2024) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12876 · Cited by 6
“Bariatric surgery is an effective method for treating adults with obesity and thereby reduce the risk of related diseases and lower all ‐ causes mortality (Aminian et al., 2019; Arterburn & Gupta, 2018).”
MethodZahid, S., Schlamp, F., Gildea, M. A., Lin, B., Hülsmeier, A. J., Chaloemtoem, A., Falis, M., Parikh, M., Fisher, E. A. A., Hornemann, T., et al. (2025) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.124.321686 · Cited by 6
COHEN, R. V., Sforza, N., & Clemente, R. (2020) · Current Hypertension Reviews · doi:10.2174/1573402116666200804153228 · Cited by 6
Metabolic Surgery: Paradigm Shift in Metabolic Syndrome/Diabetes Therapy
Rühle, A., Billeter, A. T., & Müller-Stich, B. P. (2022) · Visceral Medicine · doi:10.1159/000521707 · Cited by 6
Fernando, D. G., Saravia, F. L., Atkinson, S. N., Barron, M., Kirby, J. R., & Kindel, T. L. (2022) · Surgical Endoscopy · doi:10.1007/s00464-022-09387-4 · Cited by 6
“Bariatric surgery also reduces the increased risk of obesity-related mortality, primarily by reducing the severity and progression of cardiovascular disease [5, 6].”
BackgroundYang, W., Zhan, M., Li, Z. Y., Sun, X., & Zhang, K. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06634-y · Cited by 8
“The efficacy of lifestyle modification and pharmacotherapy is highly variable as it relies on persistent patient motivation and engagement [25, 26] and has relatively modest effects on mortality [49–51].”
BackgroundLong-term cerebrovascular outcomes after bariatric surgery: A nationwide cohort study
Moussa, O., Ardissino, M., Tang, A., Edwards, J., Heaton, T., Khan, O. A., Tsang, K., Collins, P. D., & Purkayastha, S. (2021) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2021.106560 · Cited by 6
Efficacy of bariatric surgery in COVID-19 patients: An updated systematic review and meta-analysis
Hasnain, N., Moeed, A., Waqar, E., Farhan, S. A., & Amreek, F. (2022) · Surgery in Practice and Science · doi:10.1016/j.sipas.2022.100140 · Cited by 6
Tang, N., Li, K., Li, H., Zhang, Q., Ji, H., & Qi, C.-M. (2025) · World Journal of Cardiology · doi:10.4330/wjc.v17.i2.103950 · Cited by 5
“Aminian et al [79] found that metabolic surgery not only reduces body weight and improves coronary microvascular function but also effectively controls blood pressure, blood glucose levels, and reduces the incidence of cardiovascular diseases.”
Obesity Management in South Asian Context
Das, S., Chappalagavi, A. S., Choudhury, A. K., Meher, D., Sahoo, D., Sahu, S. K., & Gupta, S. (2025) · Apollo Medicine · doi:10.1177/09760016251325966 · Cited by 5
“[47,48] However, surgery may not be suitable for all populations and is contraindicated in patients with reduced life expectancy, substance abuse, untreated schizophrenia and a”
Bottino, R., Carbone, A., Formisano, T., D’Elia, S., Orlandi, M., Sperlongano, S., Molinari, D., Castaldo, P., Palladino, A., Barbareschi, C., et al. (2023) · Life · doi:10.3390/life13071552 · Cited by 5
“7 years) with RYGB as the main bariatric procedure (63–80%) applied [62,63,152].”
Wei, J.-H., Lee, M.-H., Lee, W., Chen, S., Almalki, O. M., Chen, J., Wu, C., & Lee, Y.-C. (2022) · Asian Journal of Surgery · doi:10.1016/j.asjsur.2021.12.064 · Cited by 5
Implementation of Cardiometabolic Centers and Training Programs
Taha, M. B., Rao, N., Vaduganathan, M., Cainzos‐Achirica, M., Nasir, K., & Patel, K. V. (2022) · Current Diabetes Reports · doi:10.1007/s11892-022-01459-y · Cited by 5
Varban, O. A., Bonham, A. J., Carlin, A. M., Ghaferi, A. A., Finks, J. F., & Ehlers, A. P. (2022) · Journal of the American College of Surgeons · doi:10.1097/xcs.0000000000000306 · Cited by 5
Effect of laparoscopic sleeve gastrectomy on platelet count and mean platelet volume
Şen, O., Oray, Ş., Çalıkoğlu, İ., Sekmen, Ü., & Türkçapar, A. G. (2023) · Journal of Minimal Access Surgery · doi:10.4103/jmas.jmas_301_22 · Cited by 5
“[13] [14‑16] The present study aims to demonstrate if LSG has any effect on PLT counts, MPV and white blood cells (WBCs).”
Obesity in Heart Failure with Reduced Ejection Fraction
Amdahl, M. B., Sundaram, V., & Reddy, Y. N. V. (2023) · Cardiology Clinics · doi:10.1016/j.ccl.2023.06.010 · Cited by 5
Kheniser, K. G., Aminian, A., & Kashyap, S. R. (2020) · Current Diabetes Reports · doi:10.1007/s11892-020-01350-8 · Cited by 5
Self-citationNielsen, M. S., Søberg, S., Schmidt, J. B., Chenchar, A., Sjödin, A. M., & Gillum, M. P. (2021) · PeerJ · doi:10.7717/peerj.11174 · Cited by 5
“Roux-en-Y gastric bypass (RYGB) can lead to impressive and sustained weight loss and induce major metabolic improvements with an acute resolution of type 2 diabetes and reduced cardiovascular risk (Schauer et al., 2003; Jørgensen et al., 2012; Aminian et al., 2019).”
BackgroundPrediction of remission of type 2 diabetes mellitus after bariatric surgery
Kornyushin, O. V., Sakeian, I. S., Кравчук, Е. Н., Vasilevsky, D. I., Данилов, И. Н., & Неймарк, А. Е. (2021) · Diabetes Mellitus · doi:10.14341/dm12814 · Cited by 5
Lu, J., Pan, Y., Tu, Y., Zhang, P., Zhou, J., & Yu, H. (2022) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2022.01.012 · Cited by 5
Short-term cardiovascular events after bariatric surgery in patients with metabolic syndrome
Chumakova-Orin, M., Ingram, J. L., Que, L. G., Pagidipati, N. J., Gordee, A., Kuchibhatla, M. N., & Seymour, K. A. (2023) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2023.07.009 · Cited by 5
Wen, W., Li, Q., She, J., Bai, X., Zhang, L., Li, R., Wu, Y., Zhou, J., & Yuan, Z. (2024) · Scientific Reports · doi:10.1038/s41598-023-50304-z · Cited by 5
Impact of bariatric surgery on the risk of hospitalization due to influenza virus infection
Valera, R. J., Fonnegra, C. B., Cogollo, V. J., Montorfano, L. M., Sarmiento-Cobos, M. F., Rivera, C. E., Liang, H., Menzo, E. L., Szomstein, S., & Rosenthal, R. J. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.08.013 · Cited by 5
Renal Outcomes 1 Year After Metabolic Bariatric Surgery in a Multi-ethnic Asian Cohort
Wee, Z., Ganguly, S., Tham, K. W., Lim, C. H., Tan, J. T. H., & Lee, P. C. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05732-z · Cited by 5
Suissa, K., Schneeweiß, S., Glynn, R. J., Wexler, D. J., Suissa, S., Paik, J. M., & Patorno, E. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15771 · Cited by 4
“7,28 This confirms our concerns that these electronic health record-based studies have important methodological challenges regarding major clinical events.”
Pearson‐Stuttard, J., Chan, M. S., Holloway, S., Matthiessen, K. S., Thompson, A. R., & Capucci, S. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.16271 · Cited by 4
“Weight loss via a range of methods could improve CV outcomes: care pathways for overweight and obesity include bariatric surgery 17 – 20 ; intensive lifestyle intervention or diabetes support and education 21 ; and pharmacotherapy.”
Zahid, S., Peng, A. W., Razavi, A. C., Yao, Z., Blumenthal, R. S., & Blaha, M. J. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.101281 · Cited by 6
“Large cohort studies and meta-analyses demonstrate significant reductions in major adverse cardiovascular events, stroke, heart failure, and all-cause mortality [43 – 46].”
Albor, C., Anyiam, O., Boyle, L., Makaronidis, J., Tan, R. J. L., Iftikhar, S., Burzić, A., Lajeunesse‐Trempe, F., Stanley, M., Bhatti, A. I., et al. (2026) · Current Obesity Reports · doi:10.1007/s13679-026-00707-6 · Cited by 5
Bays, H. E., Varney, C., Alexander, L., Ng, J., Tondt, J., Weber, C., Christensen, S. M., Burridge, K., Brown, C., Bindlish, S., et al. (2026) · Obesity Pillars · doi:10.1016/j.obpill.2026.100283 · Cited by 4
Impact of medical versus surgical weight loss on cardiovascular outcomes
Ostapenko, A., & Ahmed, B. H. (2025) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2025.03.004 · Cited by 4
Kaur, K. K. (2022) · Open Access Journal of Endocrinology · doi:10.23880/oaje-16000164 · Cited by 4
Can Nonalcoholic Steatohepatitis Be Surgically Cured?
Aminian, A., Wilson, R. L., Al‐Kurd, A., Bena, J., Fayazzadeh, H., Alkhouri, N., Nissen, S. E., & Dasarathy, S. (2023) · Annals of Surgery · doi:10.1097/sla.0000000000005914 · Cited by 4
Self-citationMid-Long-Term Effect of Metabolic Surgery on Type 2 Diabetes in Nonobese Patients: a Meta-analysis
Zou, X., Liu, Z., Huang, Z., Huang, J., Wang, X., Chen, Y., Yang, J., & Guan, B. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06713-0 · Cited by 4
“Keywords Type 2 diabetes · Non-obese · Metabolic surgery · Mid-long-term · Meta-analysis Introduction During the past decades, bariatric surgery has been regarded as the most effective option for obesity (defined as body mass index (BMI) ≥ 30 kg/m2); it can result in remarkable weight reduction as well as improve obes…”
BackgroundNudel, J., Kenzik, K. M., Rajendran, I., Hofman, M., Srinivasan, J., Woodson, J., & Hess, D. T. (2023) · Obesity · doi:10.1002/oby.23911 · Cited by 4
“Patients receiving WLS enjoy improved quality of life [ 7], lower cardiovascular risk [8], improved COVID-19 outcomes [9], and reduced mortality [ 10, 11].”
BackgroundStenberg, E., Cao, Y., Ottosson, J., Hedberg, S., & Näslund, E. B. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15952 · Cited by 5
“…obesity and T2D results in the remission of T2D in about 60% of patients, 5,6 remission of hypertension in 40% – 50% 7,8 resulting in improvements of cardiovascular disease, including a lower risk for major adverse cardiovascular events, 9 and the remission of obstructive sleep apnoea in about 60%.”
Anderson, J. J., Deo, S. V., Welsh, P. I., Mackay, D., Ho, F. K. W., Ferguson, L. D., Celis-Morales, C. A., Gill, J. M. R., Pell, J. P., & Sattar, N. A. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15949 · Cited by 4
“However, whether large-scale weight loss over a period of time may also lower MACE risk is a question to be answered with some supportive data from bariatric surgery observational data 21 and a recent 10-year follow-up of a randomised trial in diabetes.”
Hinerman, A. S., Khoudary, S. R. E., Wahed, A. S., Courcoulas, A. P., Barinas‐Mitchell, E., & King, W. C. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.12.013 · Cited by 3
Valera, R. J., Fonnegra, C. B., Sarmiento-Cobos, M. F., Rivera, C. E., Montorfano, L. M., Alemán, R., Alonso, M., Menzo, E. L., Szomstein, S., & Rosenthal, R. J. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.08.023 · Cited by 4
Friedman, A. N., Schauer, P. R., Beddhu, S., Kramer, H., le Roux, C. W., Purnell, J. Q., Sunwold, D., Tuttle, K. R., Jastreboff, A. M., & Kaplan, L. M. (2022) · Obesity · doi:10.1002/oby.23599 · Cited by 4
Self-citationPané, A., Viaplana, J., Giró, O., Llopis, J., Ibarzábal, A., de Hollanda, A., Vidal, J., Ortega, E., Jiménez, A., & Chiva‐Blanch, G. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad473 · Cited by 4
Metadata
- Authors
- Aminian, A., Zajichek, A., Arterburn, D. E., Wolski, K. E., Brethauer, S. A., Schauer, P. R., Kattan, M. W., & Nissen, S. E.
- Affiliations
- Cleveland Clinic (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Corresponding author
- Nissen, Steven E.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2019-10-01
- Volume
- 322
- Issue
- 13
- Pages
- 1271
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC6724187
- OpenAlex
- W2970007463
- Cited by
- 505
- References
- 32
- Citations by year
- 2026: 61 · 2025: 71 · 2024: 68 · 2023: 73 · 2022: 66 · 2021: 83 · 2020: 73 · 2019: 9
- FWCI
- 55.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Keywords
- metabolic surgery, type 2 diabetes, obesity, major adverse cardiovascular events, cardiovascular outcomes, bariatric surgery, weight loss, myocardial infarction, ischemic stroke, heart failure, atrial fibrillation, kidney disease, mortality, cardiometabolic risk factors
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