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21.01.2022 | Original Contributions

Long-term Impact of Bariatric Surgery on Major Adverse Cardiovascular Events in Patients with Obesity, Diabetes and Hypertension: a Population-level Study

verfasst von: Philippe Bouchard, Safiya Al-Masrouri, Sebastian Demyttenaere, Olivier Court, Amin Andalib

Erschienen in: Obesity Surgery | Ausgabe 3/2022

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Abstract

Background

The literature on long-term impact of bariatric/metabolic surgery on incidence of major adverse cardiovascular events (MACE) in patients with obesity and metabolic syndrome is still lacking. We aimed to evaluate the long-term relationship between metabolic surgery and MACE in such patients.

Methods

In a population-based cohort study, we compared all patients with obesity, diabetes mellitus (DM) and/or hypertension (HTN), who underwent bariatric surgery in Quebec, Canada during 2007–2012, with matched controls with obesity. The incidence of a composite MACE outcome (coronary artery events, heart failure, cerebrovascular events, and all-cause mortality) after bariatric surgery was compared between both groups. Cox regression was used to evaluate the long-term impact of surgery on MACE outcomes.

Results

The study cohort included 3627 surgical patients, who were matched to 5420 controls with obesity. Baseline demographics were comparable between groups, but DM was more prevalent among the surgical group. Median follow-up time was 7.05 years for the study cohort (range: 5–11 years). There was a significant long-term difference in the incidence of MACE between the surgical group and controls (19.6% vs. 24.8%, respectively; p < 0.01). After accounting for confounders, bariatric surgery remained an independent protective predictor of long-term MACE (hazard ratio [HR], 0.83 [95%CI, 0.78–0.89]). The 10-year absolute risk reduction (ARR) for the surgical group was 5.14% (95%CI, 3.41–6.87).

Conclusions

Among patients with obesity, DM and HTN, bariatric/metabolic surgery is associated with a sustained (≥ 10 years) decrease in the incidence of MACE. The results from this population-level observational study should be validated in randomized controlled trials.

Graphical abstract

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Metadaten
Titel
Long-term Impact of Bariatric Surgery on Major Adverse Cardiovascular Events in Patients with Obesity, Diabetes and Hypertension: a Population-level Study
verfasst von
Philippe Bouchard
Safiya Al-Masrouri
Sebastian Demyttenaere
Olivier Court
Amin Andalib
Publikationsdatum
21.01.2022
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 3/2022
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05849-1

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