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315 with severe obesity and concomitant type 2 dia‐ betes mellitus in the absence of pre ‐existing CAD has been shown to reduce the 5 ‐year risk for in‐ cident CAD, macrovascular composite outcome and all ‐cause death compared with the nonsur‐ gical group.4 In a more recent retrospective co‐ hort study, also enrolling subjects with type 2 diabetes mellitus and morbid obesity (including, however, participants with pre ‐existing CAD), it was demonstrated that metabolic surgery is as‐ sociated with a significant decrease in the 8 ‐year risk for the primary composite cardiovascular outcome and for CAD events, as well, compared with nonsurgical management.5 Collectively, it seems that we have, for the first time, treatment options for optimal manage‐ ment of obese patients with concomitant CAD, in order to decrease cardiovascular morbidity and mortality and all ‐cause mortality. It would be interesting to document prospectively in sur‐ veys similar to that conducted by Kozieł et al1 whether current knowledge affects physicians’ treatment preferences and the impact of such in‐ terventions on the quality of life and outcomes of specific interest of affected patients. In addi‐ tion, it would be valuable to know whether there is a gender ‐specific phenotype and the effect of applied treatment on disease course and over‐ all prognosis.

The obesity pandemic among patients with coronary artery disease: do we have enough to tackle its progression?