Amgad Mentias, MD, MS, FACC, FEDSC, Clinical Cardiologist at the Cleveland Clinic. In this video, he speaks about the abstract Long-Term Cardiovascular Outcomes After Bariatric Surgery in the Medicare Population.

Observation -

Origins:

The long-term impact of bariatric surgery on cardiovascular outcomes in the senior population has not been well investigated.

Purpose:

The purpose of this study was to look at the relationship between bariatric surgery and long-term cardiovascular outcomes in the Medicare group.

Methodologies:

Medicare beneficiaries who underwent bariatric surgery between 2013 and 2019 were matched to a control group of obese patients using a 1:1 exact match based on age, gender, BMI, and propensity score matching on 87 clinical characteristics. All-cause mortality, new-onset heart failure (HF), myocardial infarction (MI), and ischemic stroke were among the study's results. As a sensitivity analysis, an instrumental variable analysis was undertaken.

Outcomes:

There were 189,770 patients in the study cohort (94,885 matched patients in each group). According to the study design, the two groups were similar in age (mean: 62.33 10.62 years), gender (70 percent female), and degree of obesity (mean body mass index: 44.7 7.3 kg/m2), as well as on all clinical characteristics. Bariatric surgery was linked with a decreased risk of death (9.2 vs 14.7 per 1,000 person-years; HR: 0.63; 95 percent CI: 0.60-0.66), new-onset HF (HR: 0.46; 95 percent CI: 0.44-0.49), MI (HR: 0.63; 95 percent CI: 0.59-0.68), and stroke (HR: 0.71; 95 percent CI: 0.65-0.79) (P 0.001). The benefit of bariatric surgery was seen in patients aged 65 and up. Using instrumental variable analysis, bariatric surgery was linked to a decreased risk of death, heart failure, and MI.

Observations:

Bariatric surgery is related with a decreased risk of death, new-onset HF, and MI among Medicare seniors who are obese.