Impact of bariatric surgery on cardiovascular outcomes and mortality: a population‐based cohort study

Research output: Contribution to journalArticle

Standard

Harvard

APA

Vancouver

Author

Bibtex

@article{843b8b004a97468eba13185a8d03f80d,
title = "Impact of bariatric surgery on cardiovascular outcomes and mortality: a population‐based cohort study",
abstract = "Background: Cohort studies have shown that bariatric surgery may reduce CVD incidence and mortality, but studies using real world data are limited. We conducted a population-based study examining the impact of bariatric surgery (BS) on incident cardiovascular disease(CVD), hypertension, atrial fibrillation and all-cause mortality. Methods: A retrospective matched, controlled cohort study between 1/1/1990 and 31/1/2018 using The Health Improvement Network (THIN), primary care electronic database. Adults with a BMI ≥ 30 kg/m2 who did not have gastric cancer were included in exposed group.Each exposed patient (had BS) was matched for age, sex, body mass index (BMI) & presenceof type 2 diabetes (T2D) to 2 controls (not had BS). Results: 5170 exposed and 9995 control participants were included. Mean (SD) age was 45.3(10.5) years, 21.5% (n=3265) had T2D. The median follow-up was 3.9 years (IQR 1.8- 6.4).BS was associated with a lower incident CVD (adjusted HR 0.80; 95%CI 0.62- 1.02,p=0.074), which was statistically significant in the gastric bypass group (0.53, 0.34- 0.81,p=0.003). BS was associated with significant reduction in all-cause mortality (0.70; 95%CI0.55- 0.89, p=0.004), hypertension (0.41; 0.34- 0.50, p<0.001) and heart failure (0.57, 0.34-0.96; p=0.033). Outcomes were similar in those with and without T2D (exposed vs control)except incident AF which was reduced in T2D cohort Conclusions: BS was associated with a reduced risk of incident hypertension, CVD, and mortality in real-world data. Improvements in the provision of BS can help reduce the burden of obesity.",
author = "Pushpa Singh and Anuradhaa Subramanian and Nicola Adderley and Krishna Gokhale and Rishi Shinghal and Srikanth Bellary and Krishnarajah Nirantharakumar and Abd Tahrani",
note = " https://doi.org/10.1002/bjs.11433",
year = "2020",
month = jan
day = "21",
doi = "10.1002/bjs.11433",
language = "English",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Impact of bariatric surgery on cardiovascular outcomes and mortality

T2 - a population‐based cohort study

AU - Singh, Pushpa

AU - Subramanian, Anuradhaa

AU - Adderley, Nicola

AU - Gokhale, Krishna

AU - Shinghal, Rishi

AU - Bellary, Srikanth

AU - Nirantharakumar, Krishnarajah

AU - Tahrani, Abd

N1 - https://doi.org/10.1002/bjs.11433

PY - 2020/1/21

Y1 - 2020/1/21

N2 - Background: Cohort studies have shown that bariatric surgery may reduce CVD incidence and mortality, but studies using real world data are limited. We conducted a population-based study examining the impact of bariatric surgery (BS) on incident cardiovascular disease(CVD), hypertension, atrial fibrillation and all-cause mortality. Methods: A retrospective matched, controlled cohort study between 1/1/1990 and 31/1/2018 using The Health Improvement Network (THIN), primary care electronic database. Adults with a BMI ≥ 30 kg/m2 who did not have gastric cancer were included in exposed group.Each exposed patient (had BS) was matched for age, sex, body mass index (BMI) & presenceof type 2 diabetes (T2D) to 2 controls (not had BS). Results: 5170 exposed and 9995 control participants were included. Mean (SD) age was 45.3(10.5) years, 21.5% (n=3265) had T2D. The median follow-up was 3.9 years (IQR 1.8- 6.4).BS was associated with a lower incident CVD (adjusted HR 0.80; 95%CI 0.62- 1.02,p=0.074), which was statistically significant in the gastric bypass group (0.53, 0.34- 0.81,p=0.003). BS was associated with significant reduction in all-cause mortality (0.70; 95%CI0.55- 0.89, p=0.004), hypertension (0.41; 0.34- 0.50, p<0.001) and heart failure (0.57, 0.34-0.96; p=0.033). Outcomes were similar in those with and without T2D (exposed vs control)except incident AF which was reduced in T2D cohort Conclusions: BS was associated with a reduced risk of incident hypertension, CVD, and mortality in real-world data. Improvements in the provision of BS can help reduce the burden of obesity.

AB - Background: Cohort studies have shown that bariatric surgery may reduce CVD incidence and mortality, but studies using real world data are limited. We conducted a population-based study examining the impact of bariatric surgery (BS) on incident cardiovascular disease(CVD), hypertension, atrial fibrillation and all-cause mortality. Methods: A retrospective matched, controlled cohort study between 1/1/1990 and 31/1/2018 using The Health Improvement Network (THIN), primary care electronic database. Adults with a BMI ≥ 30 kg/m2 who did not have gastric cancer were included in exposed group.Each exposed patient (had BS) was matched for age, sex, body mass index (BMI) & presenceof type 2 diabetes (T2D) to 2 controls (not had BS). Results: 5170 exposed and 9995 control participants were included. Mean (SD) age was 45.3(10.5) years, 21.5% (n=3265) had T2D. The median follow-up was 3.9 years (IQR 1.8- 6.4).BS was associated with a lower incident CVD (adjusted HR 0.80; 95%CI 0.62- 1.02,p=0.074), which was statistically significant in the gastric bypass group (0.53, 0.34- 0.81,p=0.003). BS was associated with significant reduction in all-cause mortality (0.70; 95%CI0.55- 0.89, p=0.004), hypertension (0.41; 0.34- 0.50, p<0.001) and heart failure (0.57, 0.34-0.96; p=0.033). Outcomes were similar in those with and without T2D (exposed vs control)except incident AF which was reduced in T2D cohort Conclusions: BS was associated with a reduced risk of incident hypertension, CVD, and mortality in real-world data. Improvements in the provision of BS can help reduce the burden of obesity.

U2 - 10.1002/bjs.11433

DO - 10.1002/bjs.11433

M3 - Article

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

ER -