Does bariatric surgery reduce the risk of major cardiovascular events? A retrospective cohort study of morbidly obese surgical patients.

Morbid obesity is associated with the development of cardiovascular and cerebrovascular disease. Several studies have shown that bariatric surgery results in risk factor reduction; however, studies correlating bariatric surgery to the reduced rates of myocardial infarction, stroke, or death have been limited. We conducted a large retrospective cohort study of bariatric (BAR) surgical patients (n = 4747) and morbidly obese orthopedic (n = 3066) and gastrointestinal (n = 1327) surgical controls. Data were obtained for all patients aged 40-79 years, from 1996 to 2008, with a diagnosis code of morbid obesity and a primary surgical procedure of interest. The data sources were the statewide South Carolina Universal Billing Code of 1992 inpatient hospitalization database and death records. The primary study outcome was the time-to-occurrence of the composite outcome of postoperative myocardial infarction, stroke, or death (all-cause). The 5-year Kaplan-Meier life table estimate of the composite index of event-free survival in the BAR, orthopedic, and gastrointestinal cohorts was 84.8%, 72.8%, and 65.8%, respectively. After adjusting for baseline differences and potential confounders, the Cox proportional hazards ratio was .72 (95% confidence interval .58-.89) for BAR versus orthopedic and .48 (95% confidence interval .39-.61) for BAR versus gastrointestinal. Bariatric surgery was significantly associated with a 25-50% risk reduction in the composite index of postoperative myocardial infarction, stroke, or death compared with other morbidly obese surgical patients in South Carolina.

Scott JD ，Johnson BL ，Blackhurst DW ，Bour ES ... -  《-》

Bariatric surgery is associated with a reduced risk of mortality in morbidly obese patients with a history of major cardiovascular events.

Johnson RJ ，Johnson BL ，Blackhurst DW ，Bour ES ，Cobb WS 4th ，Carbonell AM 2nd ，Lokey JS ，Scott JD ... -  《-》

Bariatric surgery is associated with a reduction in major macrovascular and microvascular complications in moderately to severely obese patients with type 2 diabetes mellitus.

Bariatric surgery (BAR) has been established as an effective treatment for type 2 diabetes mellitus (T2DM) in obese patients. However, few studies have examined the mid- to long-term outcomes of bariatric surgery in diabetic populations. Specifically, no comparative studies have broadly examined major macrovascular and microvascular complications in bariatric surgical patients vs similar, nonbariatric surgery controls. We conducted a large, population-based, retrospective cohort study of adult obese patients with T2DM, from 1996 to 2009, using UB-04 administrative data and vital records. Eligible patients undergoing bariatric surgery (BAR [n = 2,580]) were compared with nonbariatric surgery controls (CON [n = 13,371]) for the outcomes of any first major macrovascular event (myocardial infarction, stroke, or all-cause death) or microvascular event (new diagnosis of blindness, laser eye or retinal surgery, nontraumatic amputation, or creation of permanent arteriovenous access for hemodialysis), assessed in combination and separately, as well as other vascular events (carotid, coronary or lower extremity revascularization or new diagnosis of congestive heart failure or angina pectoris). Bariatric surgery was associated with favorable unadjusted 5-year event-free survival estimates for the combined primary outcome (95% ± 1% vs 81% ± 1%, log-rank p < 0.01) and each secondary outcome (log-rank p < 0.01). Multivariate-adjusted and propensity-based relative risk estimates showed BAR to be associated with a 60% to 70% reduction (adjusted hazard ratio [HR] 0.36, 95% CI 0.27 to 0.47) in the combined primary outcome and 60% to 80% risk reductions for each secondary outcome (macrovascular events [adjusted HR 0.39, 95% CI 0.29 to 0.51]; microvascular events [adjusted HR 0.22, 95% CI 0.09 to 0.49]; and other vascular events [adjusted HR 0.25, 95% CI 0.19 to 0.32]). Bariatric surgery is associated with a 65% reduction in major macrovascular and microvascular events in moderately and severely obese patients with T2DM.

Johnson BL ，Blackhurst DW ，Latham BB ，Cull DL ，Bour ES ，Oliver TL ，Williams B ，Taylor SM ，Scott JD ... -  《-》

Natural history of morbid obesity without surgical intervention.

Sowemimo OA ，Yood SM ，Courtney J ，Moore J ，Huang M ，Ross R ，McMillian U ，Ojo P ，Reinhold RB ... -  《-》

Mortality after bariatric surgery: analysis of 13,871 morbidly obese patients from a national registry.

Morino M ，Toppino M ，Forestieri P ，Angrisani L ，Allaix ME ，Scopinaro N ... -  《-》