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A Retrospective Chart Review of Patients Who Underwent Cardiac Evaluation Before Bariatric Surgery
Maher Nasser1, Evelyn Calderon2, Miray Kurtca3
1Baylor College of Medicine; Baylor St. Luke's Medical Center; CHI Health System; Texas Heart Institute; HCA Healthcare; Houston Methodist Hospital, Houston, TX, USA.
Insights
This study found no high prevalence of cardiovascular disease in obese patients seeking bariatric surgery. Coronary artery disease (CAD) was not common in this selected group, suggesting bariatric surgery candidates may have lower cardiovascular risk than anticipated.
Area of Science:
- Cardiology
- Obesity Medicine
- Bariatric Surgery
Background:
- Obesity is a global pandemic linked to hypertension, diabetes, and hyperlipidemia, increasing cardiovascular disease (CVD) risk.
- Understanding CVD prevalence in obese individuals is crucial for managing associated health risks.
Purpose of the Study:
- To evaluate the prevalence of cardiovascular disease in obese patients undergoing pre-bariatric surgery evaluation.
- To identify specific cardiovascular conditions within this patient cohort.
Main Methods:
- Retrospective observational chart review of obese patients (2004-2020) seeking cardiovascular clearance for bariatric surgery.
- Collected data included demographics, risk factors, and existing cardiovascular diseases (CVD).
- Utilized non-invasive testing (ECG, echocardiograms, stress tests) and invasive procedures (coronary angiograms) when indicated.
Main Results:
- Out of 761 obese patients, 7.6% (58) underwent coronary angiograms.
- 17 patients (2.2% of total cohort) were found to have significant coronary artery disease (CAD).
- This cohort is a selected group intended for bariatric surgery, potentially influencing generalizability.
Conclusions:
- The study population showed no high prevalence of cardiovascular disease, including coronary atherosclerosis, dilated cardiomyopathy, left ventricular hypertrophy, heart failure, atrial fibrillation, stroke, venous thrombosis, and obstructive sleep apnea.
- Findings suggest that obese patients selected for bariatric surgery may have a lower prevalence of certain cardiovascular conditions compared to the general obese population.
- Further research is needed to confirm these findings in broader populations.
Background:
Overweight and obesity are considered to be a global pandemic. Its associations with hypertension, diabetes and hyperlipidemia are important risk factors for cardiovascular diseases.
Methods:
This was a retrospective, observational chart review of obese patients who were seen in our outpatient clinic for cardiovascular clearance prior to an intended bariatric surgery between 2004 and 2020. Data from patient's demographics, risk factors, presence of coronary artery disease (CAD) and other cardiovascular diseases were collected from medical charts. They underwent clinical evaluation, non-invasive workup including electrocardiograms, echocardiograms, treadmill exercise tests and some of them myocardial perfusion studies and coronary angiograms when indicated, based on their symptoms and/or risk factors for CAD.
Results:
From 761 patients studied, 7.6% (58 patients) underwent coronary angiograms, based on their non-invasive workup and their history. Among them, we found that 17 patients had significant CAD. It should be mentioned that this is a selected group of patients with the intention to undergo a bariatric surgical procedure, which this makes them somewhat different from the general population, and this could be considered among the limitations of our study.
Conclusions:
Data from our selected population chart review showed that in this specific population, there was no high prevalence of cardiovascular disease, specifically coronary atherosclerosis, dilated cardiomyopathy, left ventricular hypertrophy, heart failure, atrial fibrillation, stroke, venous thrombosis and obstructive sleep apnea.
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