Cardiovascular risk after bariatric surgery for obesity

被引:77
|
作者
Batsis, John A. [1 ,2 ]
Sarr, Michael G. [3 ]
Collazo-Clavell, Maria L. [2 ,4 ]
Thomas, Randal J. [2 ,5 ]
Romero-Corral, Abel [5 ]
Somers, Virend K. [2 ,5 ]
Lopez-Jimenez, Francisco [2 ,5 ]
机构
[1] Mayo Clin, Coll Med, Div Primary Care Internal Med, Rochester, MN 55905 USA
[2] Mayo Clin, Coll Med, Dept Med, Rochester, MN USA
[3] Mayo Clin, Coll Med, Dept Surg, Rochester, MN USA
[4] Mayo Clin, Coll Med, Div Endocrinol & Metab, Rochester, MN USA
[5] Mayo Clin, Coll Med, Div Cardiovasc Dis, Rochester, MN USA
来源
AMERICAN JOURNAL OF CARDIOLOGY | 2008年 / 102卷 / 07期
关键词
D O I
10.1016/j.amjcard.2008.05.040
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Obese patients have an increased prevalence of cardiovascular (CV) risk factors, which improve with bariatric surgery, but whether bariatric surgery reduces long-term CV events remains ill defined. A systematic review of published. research was conducted, and CV risk models were applied in a validation cohort previously published. A standardized MEDLINE search using terms associated with obesity, bariatric surgery, and CV risk factors identified 6 test studies. The validation cohort consisted of a population-based, historical cohort of 197 patients who underwent Roux-en-Y gastric bypass and 163 control patients, identified through the Rochester Epidemiology Project. Framingham and Prospective Cardiovascular Munster Heart Study (PROCAM) risk scores were applied to calculate 10-year CV risk. In the validation cohort, absolute 10-year Framingham risk score for CV events was lower at follow-up in the bariatric surgery group (7.0% to 3.5%, p <0.001) compared with controls (7.1% to 6.5%, p = 0.13), with an intergroup absolute difference in risk reduction of 3% (p <0.001). PROCAM risk in the bariatric surgery group decreased from 4.1% to 2.0% (p <0.001), whereas the control group exhibited only a modest decrease (4.4% to 3.8%, p = 0.08). Using mean data from the validation study, the trend and directionality in risk was similar in the Roux-en-Y group. The test studies confirmed the directionality of CV risk, with estimated relative risk reductions for bariatric surgery patients ranging from 18% to 79% using the Framingham risk score compared with 8% to 62% using the PROCAM risk score. In conclusion, bariatric surgery predicts long-term decreases in CV risk in obese patients. (C) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:930 / 937
页数:8
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