Effect of bariatric surgery on long-term cardiovascular outcomes: a nationwide nested cohort study
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
AIMS: This study aims to evaluate the long-term effect of bariatric surgery on cardiovascular outcomes of patients with obesity. METHODS AND RESULTS: A nested cohort study was carried out within the Clinical Practice Research Datalink. The study cohort included the 3701 patients on the database who had undergone bariatric surgery and 3701 age, gender, and body mass index-matched controls. The primary endpoint was the composite of fatal or non-fatal myocardial infarction and fatal or non-fatal ischaemic stroke. Secondary endpoints included fatal or non-fatal myocardial infarction alone, fatal or non-fatal ischaemic stroke alone, incident heart failure, and mortality. The median follow-up achieved was 11.2 years. Patients who had undergone bariatric surgery had a significantly lower occurrence of major adverse cardiovascular events [hazard ratio (HR) 0.410, 95% confidence interval (CI) 0.274-0.615; P < 0.001]. This was mainly driven by a reduction in myocardial infarction (HR 0.412, 95% CI 0.280-0.606; P < 0.001) and not in acute ischaemic stroke (HR 0.536, 95% CI 0.164-1.748; P = 0.301). A reduction was also observed in new diagnoses of heart failure (HR 0.403, 95% CI 0.181-0.897; P = 0.026) and mortality (HR 0.254, 95% CI 0.183-0.353; P < 0.001). CONCLUSION: The results of this large, nationwide cohort study support the association of bariatric surgery with lower long-term risk of major cardiovascular events and incident heart failure in patients with obesity.
Date Issued
2020-03-19
Date Acceptance
2020-02-07
Citation
European Heart Journal, 2020, 41 (28), pp.2660-2667
ISSN
0195-668X
Publisher
Oxford University Press (OUP)
Start Page
2660
End Page
2667
Journal / Book Title
European Heart Journal
Volume
41
Issue
28
Copyright Statement
© The Author(s) 2020. Published on behalf of the European Society of Cardiology. All rights reserved.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust
National Institute of Health Research
Imperial College Trust
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32188981
PII: 5809084
Grant Number
RDB04 79560
RD207
72100-74250
N/A
Subjects
Bariatric surgery
Ischaemic stroke
Myocardial infarction
Obesity
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2020-03-19