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减轻腹部手术后心血管疾病的风险,基于新的预防方程
Lei Wang1, Xinmeng Zhang2, You Chen3
1Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
medRxiv : the preprint server for health sciences
|August 16, 2024
概括
减肥手术显著改善心血管-脏-代谢健康,并在两年内将心力衰竭风险降低50%以上. 这些改进突出了外科手术的优势.
科学领域:
- 心血管医学 心血管医学
- 代谢健康 代谢健康
- 外科手术的结果
背景情况:
- 减肥手术越来越多地进行,需要评估其对心血管-脏-代谢 (CKM) 健康的长期影响.
- 心血管疾病 (CVD) 仍然是一个重大问题,其风险分层至关重要,特别是腹腔术后的手术.
研究的目的:
- 评估减肥手术对CKM健康的影响,并估计心血管疾病风险的变化,包括心力衰竭 (HF).
- 利用新的预测心血管疾病风险事件 (PREVENT) 方程来评估这一群体的风险.
主要方法:
- 从1999年至2022年间,对7804名接受了减肥手术的患者进行了回顾性分析.
- 提取了手术前后的心血管疾病风险因素 (静缩血压,胆固醇,eGFR等). ) 的情况.
- 应用社会贫困指数增强的PREVENT方程来估计10年和30年的CVD,ASCVD,CHD,中风和HF总风险.
主要成果:
- 手术后观察到CKM健康的显著改善,包括降低血压,非HDL胆固醇和糖尿病患病率,以及更高的HDL和eGFR.
- 术后10年的心血管疾病总风险在1年后降低了25.9%,在2年后降低了16.8%.
- 心力衰竭风险显示最显著的减少 (55.7%在1年,44.8%在2年),在各个患者亚组中观察到的变化.
结论:
- 腹腔外科手术显著改善CKM的健康状况,并大大降低估计的心血管疾病风险,特别是在HF.
- 降低HF风险的程度因患者人口统计学,减肥成就和先前存在的疾病而异,这表明需要进一步研究的领域.
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