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Relation of Bariatric Surgery to Inpatient Cardiovascular Outcomes (from the National Inpatient Sample)
Tran Nguyen1, Talal Alzahrani1, Ari Mandler1
1Division of Cardiology, Department of Medicine, The George Washington University, Washington, DC.
Insights
Bariatric surgery (BS) significantly reduces the risk of major adverse cardiovascular events (MACE) in obese hospitalized patients. This finding highlights BS as a protective strategy against cardiovascular complications in individuals with obesity.
Area of Science:
- Cardiology
- Bariatric Surgery
- Public Health
Background:
- Obesity is a significant public health issue in the US, affecting approximately one in three patients.
- Obesity is strongly linked to increased cardiovascular disease (CVD) mortality.
- Bariatric surgery (BS) is an effective method for excess weight reduction.
Purpose of the Study:
- To investigate the association between bariatric surgery (BS) and major adverse cardiovascular events (MACE) in obese hospitalized patients.
- To analyze the impact of BS on cardiovascular outcomes among a large cohort of US inpatients.
Main Methods:
- Retrospective analysis of 1,700,943 obese adult patients (BMI ≥35 kg/m²) from the National Inpatient Sample (2012-2016).
- Comparison of clinical characteristics and MACE rates between patients with and without a history of BS.
- Multivariate analysis adjusted for cardiovascular disease risk factors.
Main Results:
- Out of 1,700,943 obese patients, 50,296 (2.96%) had a history of BS.
- Obese patients with a history of BS showed a 1.6-fold decreased odds of MACE (OR 0.62; 95% CI, 0.60-0.65; p <0.001).
- This association remained significant after adjusting for CVD risk factors.
Conclusions:
- A history of bariatric surgery is associated with significantly lower odds of inpatient MACE in obese patients (BMI ≥35 kg/m²).
- BS may serve as a protective factor against major adverse cardiovascular events in the context of severe obesity.
- Further research can explore the long-term cardiovascular benefits of BS in obese populations.
Abstract:
Approximately one in 3 patients in the United States are obese. There is a strong association between obesity and an increased rate of cardiovascular disease (CVD)-related mortality. Bariatric surgery (BS) has emerged as an effective strategy to achieve reduction of excess weight. Our study aims to explore the relationship between BS and major adverse cardiovascular events (MACE) among obese hospitalized patients in the United States. This is a retrospective study of all obese adult patients with BMI ≥35 kg/m2 (n= 1,700,943) in the National Inpatient Sample between 2012 and 2016. Differences in the clinical characteristics of obese patients with a history of BS versus obese patients without a history of BS were analyzed as well as the association between BS and MACE after adjusting for CVD risk factors. Among 50,296 obese patients with a history of BS (2.96%), the mean age was 53 ± 12 years with the majority being female (75.32%) and Caucasian (71.85%). Multivariate analysis revealed that obese patients with a history of BS had a1.6-fold decrease odds of MACE compared with patients without BS (OR 0.62; 95% CI, 0.60 to 0.65; p <0.001). In conclusion, this study illustrates that among obese patients with BMI ≥35 kg/m2, history of BS was associated with a significantly lower odds of inpatient MACE, after adjusting for CVD risk factors.
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