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.
The long-term impact of bariatric surgery on cardiovascular outcomes in the senior population has not been well investigated.
The purpose of this study was to look at the relationship between bariatric surgery and long-term cardiovascular outcomes in the Medicare group.
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.
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.
Bariatric surgery is related with a decreased risk of death, new-onset HF, and MI among Medicare seniors who are obese.