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Cirugía bariátrica y eventos cardiovasculares a largo plazo
Lars Sjöström1, Markku Peltonen, Peter Jacobson
1Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. lars.v.sjostrom@medfak.gu.se
JAMA
|January 5, 2012
Resumen
La cirugía bariátrica redujo significativamente las muertes y los eventos cardiovasculares en adultos obesos en comparación con la atención habitual. Esta intervención de pérdida de peso ofrece protección contra los principales resultados cardiovasculares.
Área de la Ciencia:
- Salud Cardiovascular La salud cardiovascular.
- Medicina para la obesidad Medicina para la obesidad
- Innovación quirúrgica en cirugía.
Sus antecedentes:
- La obesidad es un factor de riesgo significativo para eventos cardiovasculares.
- La evidencia que apoya las intervenciones de pérdida de peso para la protección cardiovascular es limitada.
- La cirugía bariátrica representa una importante intervención de pérdida de peso para la obesidad severa.
Objetivo del estudio:
- Para investigar la asociación entre la cirugía bariátrica y los eventos cardiovasculares.
- Evaluar el impacto de la pérdida quirúrgica de peso en la mortalidad y morbilidad cardiovascular.
- Proporcionar evidencia sobre los beneficios cardiovasculares de la cirugía bariátrica en personas obesas.
Principales métodos:
- El estudio de sujetos obesos suecos (SOS) es un ensayo prospectivo, controlado y no aleatorizado.
- 2010 participantes obesos se sometieron a cirugía bariátrica; 2037 controles obesos emparejados recibieron la atención habitual.
- El seguimiento fue de un promedio de 14,7 años, analizando muertes cardiovasculares, infarto de miocardio y accidente cerebrovascular.
Principales resultados:
- La cirugía bariátrica se relacionó con menos muertes cardiovasculares (HR, 0.47; P = .002).
- La incidencia de eventos cardiovasculares totales (infarto de miocardio o accidente cerebrovascular) fue menor en el grupo de cirugía (HR, 0.67; P < .001).
- Estos hallazgos se mantuvieron significativos después de ajustar por factores de confusión.
Conclusiones:
- La cirugía bariátrica se asocia con un número reducido de muertes cardiovasculares en adultos obesos.
- Las personas obesas sometidas a cirugía bariátrica experimentan una menor incidencia de eventos cardiovasculares en comparación con las que reciben atención habitual.
- El estudio proporciona pruebas sólidas de los efectos protectores cardiovasculares de la cirugía bariátrica.
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