Long-term effect of bariatric surgery on the incidence and outcomes of obesity-related peripheral vascular disease

Title: Long-term effect of bariatric surgery on the incidence and outcomes of obesity-related peripheral vascular disease
Authors: Moussa, O
Ardissino, M
Muttoni, S
Faraj, A
Tang, A
Ziprin, P
Darzi, A
Khan, O
Collins, P
Jaffer, U
Purkayastha, S
Item Type: Conference Paper
Abstract: Background: Patients with obesity are at high risk of suffering from both arterial and venous peripheral vascular disease. Bariatric surgery is an effective and increasingly popular strategy to achieve weight reduction and for patients with obesity. The long-term impact of bariatric surgery on obesity-related morbidity is a subject of increasing research interest. Hypothesis: The aim of this study is to ascertain the impact of bariatric surgery on the long-term occurrence of peripheral vascular disease in patients with obesity. Design: The study cohort consisted of 7,892 patients in theClinical Practice Research Datalink. This a prospectively collected nation-wide database containing primary and secondary care records of consenting patients. The intervention cohort were the 3,946 patients who had undergone bariatric surgery during follow-up; their controls were 3,946 age, gender and BMI-matched controls. The primary endpoint was considered to be the development of any peripheral vascualr disease: arterial or venous. Secondary endpoints included were peripheral arterial disease alone, peripheral venous disease alone, and amputation of a limb due to any cause. The median follow-up achieved in the study was 11.5 years. Results: A total of 1,244 patients suffered a primary endpoint during follow up; bariatric surgery was associated with a reduction in primary event rates (HR=0.651, 95%CI 0.558-0.758, p<0.001); this was driven by a reduction in both arterial and venous disease. The protective effect observed was strongest in women (p int<0.001), those with diabetes (p int<0.001) and those of WHO BMI Categories I and II (p int=0.003). Amputation rates were also non-significantly reduced in the bariatric surgery cohort HR=0.443, 95%CI 0.181-1.085, p=0.075). Conclusion: Bariatric surgery was associated with a reduction in the occurrence of both arterial and venous peripheral vascular disease in patients with obesity.
Issue Date: 19-Nov-2019
Date of Acceptance: 1-Nov-2019
URI: http://hdl.handle.net/10044/1/88017
ISSN: 0009-7322
Publisher: Lippincott, Williams & Wilkins
Start Page: 1
End Page: 2
Journal / Book Title: Circulation
Volume: 140
Copyright Statement: © 2019 The Author(s)
Sponsor/Funder: National Institute of Health Research
Conference Name: Scientific Sessions of the American-Heart-Association
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status: Published
Start Date: 2019-11-16
Finish Date: 2019-11-18
Conference Place: Philadelphia, PA
Open Access location: https://www.ahajournals.org/doi/10.1161/circ.140.suppl_1.15511
Online Publication Date: 2019-11-11
Appears in Collections:Department of Surgery and Cancer
National Heart and Lung Institute
Institute of Global Health Innovation