Cirugía bariátrica y resultados cardiovasculares en pacientes con obesidad y enfermedad cardiovascular: un estudio de cohorte retrospectivo basado en la población
Ver abstracta en PubMed
Resumen
Este resumen es generado por máquina.La cirugía bariátrica reduce significativamente los eventos adversos cardiovasculares mayores (EACM) en pacientes con obesidad y enfermedad cardiovascular existente. Esto incluye un menor riesgo de mortalidad, ataque cardíaco y hospitalización por insuficiencia cardíaca.
Área De La Ciencia
- Cardiología
- Cirugía metabólica
- Medicina para la obesidad
Sus Antecedentes
- Se sabe que la cirugía bariátrica mejora los factores de riesgo cardiovascular.
- Su impacto en los eventos adversos cardiovasculares mayores (MACE) en pacientes con enfermedad cardiovascular establecida (ECV) y obesidad grave no se conoce bien.
Objetivo Del Estudio
- Investigar la asociación entre la cirugía bariátrica y el MACE en pacientes con ECV y obesidad severa.
Principales Métodos
- Un estudio de cohorte con puntuación de propensión utilizó bases de datos administrativas de toda la provincia canadiense.
- 1319 pacientes sometidos a cirugía bariátrica fueron emparejados 1:1 con controles con enfermedad cardíaca isquémica previa o insuficiencia cardíaca.
- El resultado primario fue la ECMA prolongada (mortalidad por cualquier causa, infarto de miocardio, revascularización coronaria, eventos cerebrovasculares, hospitalización por insuficiencia cardíaca).
Principales Resultados
- Durante una mediana de seguimiento de 4,6 años, la cirugía bariátrica se asoció con una reducción del 42% en el MACE prolongado (HR ajustada, 0, 58; P< 0, 001).
- Se observaron reducciones significativas del riesgo en pacientes con insuficiencia cardíaca (HR, 0,44) y enfermedad cardíaca isquémica (HR, 0,60).
- La cirugía bariátrica también redujo la incidencia de un MACE de 3 componentes y la mortalidad cardiovascular.
Conclusiones
- La cirugía bariátrica está relacionada con la disminución de la MACE en pacientes obesos con enfermedad cardiovascular.
- Se requiere una mayor validación a través de ensayos controlados aleatorios a gran escala.
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