Cardiovascular, cancer and mortality events after bariatric surgery in people with and without pre‐existing diabetes: A nationwide study

Dhalwani, Nafeesa N.; Zaccardi, Francesco; Waheed, Hina; Mytton, Jemma; Papamargaritis, Dimitris; Webb, David R.; Evison, Felicity; Lilford, Richard; Davies, Melanie J.; Khunti, Kamlesh

doi:10.1111/1753-0407.12851

Cited by 4 publications

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Advancing the understanding of clinical efficacy of bariatric surgery has focused on short-and long-term outcomes of obesity-related comorbidities, including type 2 diabetes mellitus [4,[11][12][13], primary cardiovascular risk factors [14][15][16], cardiovascular events such as myocardial infarction and stroke [17][18][19], cancer [20,21], and allcause mortality [7,9,22]. Multiple association studies relating bariatric surgery and mortality outcomes have been reported, with wide variation in study design pertaining to the following: participant number; control cohorts; mean follow-up; procedure type; age at surgery; clinical end points (i.e., life expectancy and death rates for all cause and cause specific); and presence or absence of prevalent diabetes [3,6,[23][24][25][26][27][28][29][30][31][32][33][34][35]. Study type has been predominately retrospective in nature, with the Swedish Obesity Subjects (SOS) study prospectively studied [7,22].…”

Section: Discussionmentioning

confidence: 99%

Long‐term all‐cause and cause‐specific mortality for four bariatric surgery procedures

Adams

Meeks

Fraser

et al. 2023

Obesity

View full text Add to dashboard Cite

Objective: This retrospective study incorporated long-term mortality results after different bariatric surgery procedures and for multiple age at surgery groups.Methods: Participants with bariatric surgery (surgery) and without (non-surgery) were matched (1:1) for age, sex, BMI, and surgery date with a driver license application/renewal date. Mortality rates were compared by Cox regression, stratified by sex, surgery type, and age at surgery.Results: Participants included 21,837 matched surgery and non-surgery pairs. Follow-up was up to 40 years (mean [SD], 13.2 [9.5] years). All-cause mortality was 16% lower in surgery compared with non-surgery groups (hazard ratio, 0.84; 95% CI: 0.79-0.90; p < 0.001). Significantly lower mortality after bariatric surgery was observed for both females and males. Mortality after surgery versus non-surgery decreased significantly by 29%, 43%, and 72% for cardiovascular disease, cancer, and diabetes, respectively. The hazard ratio for suicide was 2.4 times higher in surgery compared with non-surgery participants (95% CI: 1.57-3.68; p < 0.001), primarily in participants with ages at surgery between 18 and 34 years.Conclusions: Reduced all-cause mortality was durable for multiple decades, for multiple bariatric surgical procedures, for females and males, and for greater than age 34 years at surgery. Rate of death from suicide was significantly higher in surgery versus non-surgery participants only in the youngest age at surgery participants.

show abstract

Section: Discussionmentioning

confidence: 99%

Long‐term all‐cause and cause‐specific mortality for four bariatric surgery procedures

Adams

Meeks

Fraser

et al. 2023

Obesity

View full text Add to dashboard Cite

show abstract

The long-term risk of cardiovascular events in patients following bariatric surgery compared to a non-surgical population with obesity and the general population: a comprehensive national cohort study

Hung

Chen

Chin

et al. 2020

Langenbecks Arch Surg

View full text Add to dashboard Cite

Effect of Bariatric Surgery on Cardiovascular Events and Metabolic Outcomes in Obese Patients with Insulin-Treated Type 2 Diabetes: a Retrospective Cohort Study

et al. 2019

View full text Add to dashboard Cite

To compare non-fatal cardiovascular (CV) events and metabolic outcomes, among obese patients with insulin-treated type 2 diabetes who underwent bariatric surgery compared to a propensity matched non-bariatric cohort. MethodsA retrospective cohort study was conducted among 11,125 active patients with type 2 diabetes from The Health Improvement Network (THIN) database. Propensity score matching (1:6 ratio) was used to identify patients who underwent bariatric surgery (N=131) with a non-bariatric cohort (N=579). Follow-up was undertaken for 10 years (9,686 person-years) to compare differences in metabolic outcomes and CV risk events that included: Acute Myocardial Infarction (AMI), stroke, Coronary Heart Disease (CHD), Heart Failure (HF) and Peripheral Artery Disease (PAD). Cox proportional regression was used to compute the outcomes between groups. ResultsMean age was 52±13 years (60% female); baseline weight and BMI were 116±25kg and 41±9kg/m2, respectively. Significant reductions in weight and BMI were observed in bariatric and non-bariatric cohorts during 10 years of follow-up. Bariatric surgery had a significant cardio-protective effect by reducing the risk of non-fatal CHD (adjusted hazard ratio [aHR]: 0.29, 95%CI:0.16-0.52, p<0.001) and PAD events (aHR: 0.31; 95%CI:0.11-0.89; p=0.03). However, surgery had no significant effect on AMI (aHR:0.98, p=0.95), stroke (HR:0.87, p=0.76) and HF (HR:0.89, p=0.73) risks. Bariatric surgery had favourable effects on insulin-independence, HbA1c and BP.

show abstract

Cardiovascular, cancer and mortality events after bariatric surgery in people with and without pre‐existing diabetes: A nationwide study

Abstract: For patients with pre-existing diabetes, the risk of death, cardiovascular events, and cancer after bariatric surgery was higher than for those without diabetes, whose mortality risk after surgery remains 35% higher than that of the general population.

Cited by 4 publications

References 30 publications

Long‐term all‐cause and cause‐specific mortality for four bariatric surgery procedures

Long‐term all‐cause and cause‐specific mortality for four bariatric surgery procedures

The long-term risk of cardiovascular events in patients following bariatric surgery compared to a non-surgical population with obesity and the general population: a comprehensive national cohort study

Effect of Bariatric Surgery on Cardiovascular Events and Metabolic Outcomes in Obese Patients with Insulin-Treated Type 2 Diabetes: a Retrospective Cohort Study

Contact Info

Product

Resources

About