High cardiovascular risk patients benefit more from bariatric surgery than low cardiovascular risk patients

Blanco, David Gutierrez; Funes, David Romero; Giambartolomei, Giulio; Menzo, Emanuele Lo; Szomstein, Samuel; Rosenthal, Raúl J.

doi:10.1007/s00464-018-6437-0

Cited by 10 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At 6 months follow-up, there was a significant decrease in the estimated risk of fatal or nonfatal coronary events in 10 years according to the Framingham risk score (P < 0.0001) and estimated vascular age (P < 0.0001). In a recent study conducted by Blanco et al [28] involving 360 patients with bariatric surgery, LSG was the most prevalent surgery (63%), followed by RYGB (20.6%), and reported significant reduction of both atherosclerotic cardiovascular disease and Framingham risk scores at 12 months. In another study, Wei et al [29] recently investigated the benefit of CVD risk reduction after metabolic surgery in 392 obese patients with type 2 DM who had undergone LSG (87) or RYGB (305).…”

Section: Discussionmentioning

confidence: 97%

Bariatric surgery and cardiovascular outcome

et al. 2020

View full text Add to dashboard Cite

Background Obesity is recognized as a classic risk factor for atherosclerosis and subsequent cardiovascular disease (CVD). Weight loss after bariatric surgery has been associated with reduced CV mortality and total mortality in obese patients. Our aim was to study the impact of bariatric surgery on CV risk profile, cardiac structure, and function postoperatively. Results This prospective longitudinal study included 100 morbidly obese patients at final analysis. All patients were subjected to full clinical, laboratory, and echocardiographic examination at baseline and 6 months after bariatric surgery. The mean age of study population was 37.2 ± 10.49 with BMI of 47 ± 6.82. Females represented 84%. Sleeve gastrectomy and Roux-en-Y gastric bypass were performed in 79% and 21%, respectively. Surgery-related mortality and morbidity were 0.94% and 4.7%, respectively. After 6 months, there were significant decreases in BMI, heart rate, SBP, DBP, and Framingham risk score (P < 0.0001). The prevalence of risk factors decreased as follows: hypertension 24% vs. 12%, P = 0.0005; DM 21% vs. 11%, P = 0.002; dyslipidemia 32% vs. 7%, P < 0.0001; and metabolic syndrome 54% vs. 26%, P < 0.0001. Highly significant (P < 0.0001) decrease in fasting PG and 2 h PP-PG, HbA1c, ASL, ALT, fasting total cholesterol, LDL, TG, and increase in HDL were observed after bariatric surgery. There were significant shortening in QTc interval (P = 0.009), decrease in LV dimensions and LV mass index (P < 0.0001), and increase in LV EF% (P = 0.0003). BMI at follow-up showed significant positive correlation with age, Framingham risk score, and preoperative BMI (r = 0.289, P = 0.0036; r = 0.37, P = 0.0054; and r = 0.31, P = 0.0081, respectively). Conclusion In addition to enabling patients to achieve a substantial weight loss, bariatric surgery provides a myriad of health benefits. Weight reduction was associated with a favorable improvement in cardiovascular risk profile, cardiac structure, and function.

show abstract

Section: Discussionmentioning

confidence: 97%

Bariatric surgery and cardiovascular outcome

et al. 2020

View full text Add to dashboard Cite

show abstract

“…26 A retrospective observational study of 1330 people with no history of CVD undergoing bariatric surgery between 2010 and 2016 suggested that those with severe obesity and high risk of CVD benefit more from the procedure than those with obesity and low CV risk. 27 F I G U R E 1 Association of excess adiposity with major risk factors and chronic conditions. 3 Common chronic diseases are shown in red boxes.…”

Section: Bariatric Surgerymentioning

confidence: 99%

Cardiovascular outcome trials in obesity: A review

Wilding

Jacob²

2020

Obesity Reviews

View full text Add to dashboard Cite

Summary Obesity is a global epidemic associated with over 200 health complications and a significant risk of developing cardiovascular disease (CVD), partly by increasing classical risk factors such as lipid and glucose levels and blood pressure. Weight loss through lifestyle interventions, pharmacotherapy and/or bariatric surgery improves CV risk factors. Cardiovascular outcome trials (CVOTs) of anti‐obesity medications aim to evaluate the CV safety and benefits of pharmacotherapy. Many CVOTs in obesity have either failed to demonstrate a CV benefit or have been terminated prematurely because of safety issues, prompting regulatory agencies to define new requirements (based on those for CVOTs in type 2 diabetes [T2D]). CVOTs of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) in T2D have demonstrated that some GLP‐1RAs reduce CV risk and may help inform future CVOTs in obesity, given the approval of liraglutide 3.0 mg for obesity. In this review, the evidence for the link between obesity and CVD is considered in the context of studies showing that weight loss improves markers of CV risk and risk of adverse CV events. The review also examines the CVOTs in obesity that have been conducted to date and those under way, such as the SELECT trial with subcutaneous semaglutide of 2.4 mg.

show abstract