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Effect of bariatric surgery on long-term cardiovascular outcomes: a nationwide nested cohort study

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Title: Effect of bariatric surgery on long-term cardiovascular outcomes: a nationwide nested cohort study
Authors: Moussa, O
Ardissino, M
Heaton, T
Tang, A
Khan, O
Ziprin, P
Darzi, A
Collins, P
Purkayastha, S
Item 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.
Issue Date: 19-Mar-2020
Date of Acceptance: 7-Feb-2020
URI: http://hdl.handle.net/10044/1/81859
DOI: 10.1093/eurheartj/ehaa069
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/Funder: 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
Funder's Grant Number: RDB04 79560
RD207
72100-74250
N/A
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Obesity
Bariatric surgery
Myocardial infarction
Ischaemic stroke
PRIMARY-CARE
FOLLOW-UP
RISK
ASSOCIATION
DISEASE
Bariatric surgery
Ischaemic stroke
Myocardial infarction
Obesity
Bariatric surgery
Ischaemic stroke
Myocardial infarction
Obesity
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Publication Status: Published
Conference Place: England
Online Publication Date: 2020-03-19
Appears in Collections:Department of Surgery and Cancer
National Heart and Lung Institute
Faculty of Medicine
Institute of Global Health Innovation