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Updated: Jun 15, 2025

Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice
Published on: March 20, 2017
Risk of Incident Cardiovascular Events Following Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy: A Claims-based
Kristina H Lewis1, Stephanie Argetsinger2, Robert F LeCates2,3
1Department of Epidemiology & Prevention, Department of Implementation Science, Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC.
Roux en Y gastric bypass (RYGB) shows lower cardiovascular disease risk than sleeve gastrectomy (SG) for patients with type 2 diabetes or pre-existing heart conditions. For other patients, including older adults, no significant difference in risk was observed.
Area of Science:
- Cardiovascular Science
- Bariatric Surgery Outcomes
- Medical Procedure Comparison
Background:
- Bariatric surgery reduces cardiovascular disease (CVD) risk.
- Differential CVD risk effects of sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB) are not well-defined.
Purpose of the Study:
- To compare incident cardiovascular disease (CVD) event risk between SG and RYGB.
- To analyze procedural differences in CVD risk for specific patient subgroups.
Main Methods:
- Retrospective cohort study using insurance claims (2010-2021).
- Follow-up up to 5 years for major adverse cardiovascular events (MACE), myocardial infarction, stroke, heart failure, and arrhythmia.
- Multivariable Cox proportional hazards modeling for risk comparison in overall and subgroup cohorts (older adults, type 2 diabetes, pre-existing CVD).
Main Results:
- No significant difference in MACE risk between RYGB and SG in the overall cohort or older adults.
- RYGB showed a lower MACE risk compared to SG in patients with type 2 diabetes (T2D) (aHR 0.78).
- RYGB also demonstrated a lower MACE risk for patients with pre-existing CVD or elevated morbidity (aHR 0.81).
Conclusions:
- RYGB is preferable to SG for patients with T2D or pre-existing CVD.
- No relative benefit of RYGB over SG was observed for other patient groups, including older adults, within the study's time frame.
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