Bariatric surgery demonstrates good long-term CV outcomes
Bariatric surgery demonstrated significant long-term benefits for the reduction of major adverse CV events and incident HF, according to a study published in the European Heart Journal.
Bariatric surgery reduced MI, HF and mortality but not ischemic stroke, according to the researchers.
“Acute cardiovascular events are one of the largest and most hazardous consequences of obesity,” Osama Moussa, BMBCh, honorary clinical research fellow in the department of surgery and cancer at Imperial College London, and colleagues wrote.
For this analysis, 3,701 patients (median age, 36 years) who underwent bariatric surgery were matched to 3,701 controls by age, sex and BMI.
The primary endpoint of major adverse CV events, defined as fatal or nonfatal MI and fatal or nonfatal ischemic stroke, occurred less often in the bariatric surgery group compared with controls (HR = 0.41; 95% CI, 0.274-0.615), Moussa and colleagues wrote.
Researchers observed that MI was less frequent in bariatric surgery cohort compared with controls (HR = 0.412; 95% CI, 0.28-0.606). However, the risk for ischemic stroke was similar between the two groups (HR = 0.536; 95% CI 0.164-1.748).
Moreover, fewer patients in the bariatric surgery group had new diagnosis of HF during follow-up compared with controls (HR = 0.403; 95% CI, 0.181-0.897).
All-cause mortality was also lower in patients who underwent bariatric surgery compared with those who did not (HR = 0.254; 95% CI, 0.183-0.353).
“These results were observed in spite of the presence of a greater number of classical risk factors typically used for the short-term risk prediction of cardiovascular events in the bariatric surgery group at baseline,” the researchers wrote.
In other findings, patients who underwent bariatric surgery experienced greater weight loss during follow-up compared with controls (median, –4.22 kg vs. 6 kg; P < .001).
Additionally, patients who had type 2 diabetes at baseline and underwent bariatric surgery experienced greater rates of resolution of their diabetes compared with controls (HR = 3.97; 95% CI, 3.2-4.93).
“Considering that currently < 1% of eligible patients undergo bariatric surgery, and considering the wealth of emerging evidence on its far-reaching benefits that range from mental health to cancer and cardiovascular risk, it is time to investigate, consider and amend the barriers creating this treatment gap in order to provide the best standard of care and optimize long-term outcomes of patients with obesity,” the researchers wrote.