Bariatric surgery decreases monocyte-platelet aggregates in blood: a pilot study

Morbid obesity is accompanied by platelet hyperactivity, leading to thrombotic events including myocardial infarction and stroke. Bariatric surgery is an effective intervention to reduce cardiovascular risk in obesity. However, the effect of bariatric surgery on platelet function is largely unknown. This study investigated the effects of laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) on prothrombotic monocyte-platelet aggregates (MPAs), markers of platelet activation in vivo. MPA were measured in whole blood by flow cytometry before surgery and 1 and 3 months after surgery. In non-obese healthy controls, MPA level is 13 ± 2 %. MPAs are elevated in morbidly obese subjects. RYGB (n = 12 patients) decreases MPAs 1 month after surgery by a weight-independent mechanism (56 ± 6 % presurgically vs 26 ± 8 % at 1 month, p <0.01). LAGB (n = 5 patients) has a smaller weight-dependent effect (49 ± 8 % presurgically vs 32 ± 6 % at 1 month, p > 0.05). Bariatric surgery may reduce thrombotic events by alleviation of platelet overactivity.