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European Association for the Study of the Liver, European Association for the Study of Diabetes and European Association for the Study of Obesity (2024) EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Journal of Hepatology, 81, 492-542.

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• TITLE: Beyond Weight Loss: Impact of Metabolic-Bariatric Surgery on Major Adverse Cardiovascular Events in Patients with Obesity

  AUTHORS: Gustavo Alberto Gutiérrez-Barros, María Victoria Morales-Morales, Gabriela María Morales-Donado, Ana Fernanda Arenas Bartos, Cristian Daniel Ramírez Gutiérrez, María Fernanda Ballestas Jiménez, Saúl Alfonso Logreira Cervantes, Vladimir Alejandro Balza Mancipe, Luis Mario Arroyo Ortega, Salma Nasrala Nieves, Gabriela Palmett González Rubio, Mario Rafael Solórzano López, Leonel David Mendoza Daza, Marianella Mendoza Lottmann, Eduar Jadid Padilla Llorente, María Camila Cubillos Ramírez, Sebastián José Lara Escorcia, Esperanza Daniela Choles Molina

  KEYWORDS: Obesity, Metabolic-Bariatric Surgery, Major Adverse Cardiovascular Events, MACE, Gastric Bypass, Sleeve Gastrectomy, GLP-1, Cardiovascular Risk

  JOURNAL NAME: Journal of Biosciences and Medicines, Vol.14 No.7, July 17, 2026

  ABSTRACT: Obesity is a chronic cardiometabolic disease characterized by dysfunctional expansion of adipose tissue, low-grade systemic inflammation, insulin resistance, atherogenic dyslipidemia, endothelial dysfunction, and progressive cardiovascular remodeling. These mechanisms explain its close association with major adverse cardiovascular events, including acute myocardial infarction, stroke, heart failure, and cardiovascular mortality. Metabolic-bariatric surgery is no longer considered an exclusively restrictive intervention, or one directed only toward weight loss; rather, it has become established as a strategy of physiological reprogramming capable of modifying the gut-pancreas-liver-adipose tissue axis and reducing global cardiometabolic risk. This review analyzes the pathophysiological foundations linking obesity and cardiovascular disease, the cardioprotective mechanisms induced by metabolic-bariatric surgery, and the available clinical evidence on the reduction of major adverse cardiovascular events. Postoperative benefits include decreased visceral adiposity, partial restoration of the adipocyte profile, increased adiponectin, reduced leptin and inflammatory mediators, improved insulin sensitivity, incretin modulation, changes in bile acids, remodeling of the gut microbiota, and partial reversal of obesity-associated vascular and cardiac alterations.