| アブストラクト | AIMS: This study aims to evaluate the long-term effect of bariatric surgery on cardiovascular outcomes of patients with obesity. METHODS AND RESULTS: A nested cohort study was carried out within the Clinical Practice Research Datalink. The study cohort included the 3701 patients on the database who had undergone bariatric surgery and 3701 age, gender, and body mass index-matched controls. The primary endpoint was the composite of fatal or non-fatal myocardial infarction and fatal or non-fatal ischaemic stroke. Secondary endpoints included fatal or non-fatal myocardial infarction alone, fatal or non-fatal ischaemic stroke alone, incident heart failure, and mortality. The median follow-up achieved was 11.2 years. Patients who had undergone bariatric surgery had a significantly lower occurrence of major adverse cardiovascular events [hazard ratio (HR) 0.410, 95% confidence interval (CI) 0.274-0.615; P < 0.001]. This was mainly driven by a reduction in myocardial infarction (HR 0.412, 95% CI 0.280-0.606; P < 0.001) and not in acute ischaemic stroke (HR 0.536, 95% CI 0.164-1.748; P = 0.301). A reduction was also observed in new diagnoses of heart failure (HR 0.403, 95% CI 0.181-0.897; P = 0.026) and mortality (HR 0.254, 95% CI 0.183-0.353; P < 0.001). CONCLUSION: The results of this large, nationwide cohort study support the association of bariatric surgery with lower long-term risk of major cardiovascular events and incident heart failure in patients with obesity. |
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| 投稿者 | Moussa, Osama; Ardissino, Maddalena; Heaton, Tobias; Tang, Alice; Khan, Omar; Ziprin, Paul; Darzi, Ara; Collins, Peter; Purkayastha, Sanjay |
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| 組織名 | Division of Surgery and Cancer, Imperial College London, Praed Street, London, W2;1NY, UK.;Department of Medicine, Imperial College London, Exhibition Road, London SW7 2AZ,;UK.;Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and;Westminster Hospital, Fulham Road, London SW10 9NH, UK.;Department of Upper GI and Bariatric Surgery, St George's University of London,;Blackshaw Road, London SW17 0RE, UK.;Department of General Surgery, Imperial College NHS Healthcare Trust, Praed;Street, London, W2 1NY, UK.;Royal Brompton Hospital and National Heart and Lung Institute, Imperial College;London, Sydney Street, London SW3 6NP, UK.;Imperial Weight Centre, Imperial College Healthcare NHS trust, Praed Street,;London, W2 1NY, UK. |
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