From the Research
Patients undergoing gastrectomy may have a lower risk for acute coronary syndrome (ACS) compared to the general population, as suggested by a study showing that subtotal gastrectomy with Billroth II anastomosis is associated with a reduced risk of coronary heart disease, including ACS 1. The risk of ACS in patients undergoing gastrectomy is a critical consideration, as ACS is a serious condition that can lead to significant morbidity and mortality. However, the available evidence suggests that gastrectomy may actually be associated with a lower risk of ACS, at least in certain populations.
- A study published in 2017 found that patients who underwent subtotal gastrectomy with Billroth II anastomosis had a lower cumulative incidence of coronary heart disease, including ACS, compared to a non-surgical cohort 1.
- Another study published in 2020 found that laparoscopic sleeve gastrectomy was associated with a lower perioperative mortality rate, including sudden cardiac death, compared to Roux-en-Y gastric bypass in patients with a prior cardiac history 2.
- The management of ACS typically involves prompt recognition and treatment, including the use of antiplatelet therapy, anticoagulation, and coronary angiography with percutaneous or surgical revascularization 3, 4.
- In patients undergoing noncardiac surgery, including gastrectomy, the risk of ACS can be mitigated through the use of strategies such as careful fluid management, early mobilization, and optimal pain control 5. Overall, while the risk of ACS in patients undergoing gastrectomy is a concern, the available evidence suggests that gastrectomy may actually be associated with a lower risk of ACS in certain populations, and that prompt recognition and treatment can help to mitigate this risk.