Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy
Abstract Aims Prior studies have suggested causal relationships between obesity and acute cardiovascular events. It has been also known that the risk of acute cardiovascular events is reduced by bariatric surgery. However, little is known about whether bariatric surgery lowers the risk of acute card...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-08-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14414 |
| _version_ | 1827891558984187904 |
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| author | Satoshi Miyashita Keitaro Akita Yanling Zhao Kohei Hasegawa Mathew S. Maurer Shepard D. Weiner Muredach P. Reilly Hiroo Takayama Yuichi J. Shimada |
| author_facet | Satoshi Miyashita Keitaro Akita Yanling Zhao Kohei Hasegawa Mathew S. Maurer Shepard D. Weiner Muredach P. Reilly Hiroo Takayama Yuichi J. Shimada |
| author_sort | Satoshi Miyashita |
| collection | DOAJ |
| description | Abstract Aims Prior studies have suggested causal relationships between obesity and acute cardiovascular events. It has been also known that the risk of acute cardiovascular events is reduced by bariatric surgery. However, little is known about whether bariatric surgery lowers the risk of acute cardiovascular events in patients with obesity and hypertrophic cardiomyopathy (HCM). In this context, we aimed to investigate whether bariatric surgery is associated with a reduced risk of cardiovascular‐related acute care use in patients with HCM. Methods and results In this population‐based study, the bariatric surgery group consisted of patients with HCM who underwent bariatric surgery from January 2004 to December 2014. The control group included those who have obesity and HCM and received non‐bariatric elective intra‐abdominal surgery during the same period. The outcome was cardiovascular‐related acute care use (i.e. emergency department (ED) visits or unplanned hospitalizations for cardiovascular disease) during a 1‐year post‐surgery period. We used the SPARCS database, a population‐based ED and inpatient database in New York State. We constructed logistic regression models with generalized estimating equations to compare the risk of the outcome events during sequential 6‐month post‐surgery periods. We adjusted for age, sex, number of ED visits and hospitalizations for cardiovascular disease within 2 years before the index surgery, and the Elixhauser co‐morbidity measures. We also performed propensity score (PS)‐matching and inverse probability treatment weighting analyses using these variables. The analytic cohort consisted of 207 adults with obesity and HCM, including 147 patients who underwent bariatric surgery and 60 in the control group. The risk was not significantly different in the 1–6 months post‐surgery period. By contrast, in the 7–12 months post‐surgery period, the risk of cardiovascular‐related acute care use was significantly lower in the bariatric surgery group (adjusted odds ratio 0.23; 95% CI 0.068–0.71; P = 0.01) compared with the control group. In the PS‐matched cohort, there were no significant differences in the baseline characteristics. The PS‐matched analysis demonstrated lower risk of the outcome event in the bariatric surgery group in the 7–12 months post‐surgery period. The inverse probability treatment weighting analysis replicated the findings. Conclusions Bariatric surgery was associated with a lower risk of cardiovascular‐related acute care use in the 7–12 months post‐surgery period in this population‐based study. |
| first_indexed | 2024-03-12T21:26:26Z |
| format | Article |
| id | doaj.art-53975e698d7040a696373c8dc5729cbe |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-12T21:26:26Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-53975e698d7040a696373c8dc5729cbe2023-07-28T06:30:48ZengWileyESC Heart Failure2055-58222023-08-011042438244610.1002/ehf2.14414Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathySatoshi Miyashita0Keitaro Akita1Yanling Zhao2Kohei Hasegawa3Mathew S. Maurer4Shepard D. Weiner5Muredach P. Reilly6Hiroo Takayama7Yuichi J. Shimada8Department of Medicine Tufts Medical Center and Tufts University School of Medicine Boston MA USADepartment of Medicine, Division of Cardiology Columbia University Irving Medical Center New York NY USADepartment of Surgery, Division of Cardiothoracic Surgery Columbia University Irving Medical Center New York NY USADepartment of Emergency Medicine, Massachusetts General Hospital Harvard Medical School Boston MA USADepartment of Medicine, Division of Cardiology Columbia University Irving Medical Center New York NY USADepartment of Medicine, Division of Cardiology Columbia University Irving Medical Center New York NY USADepartment of Medicine, Division of Cardiology Columbia University Irving Medical Center New York NY USADepartment of Surgery, Division of Cardiothoracic Surgery Columbia University Irving Medical Center New York NY USADepartment of Medicine, Division of Cardiology Columbia University Irving Medical Center New York NY USAAbstract Aims Prior studies have suggested causal relationships between obesity and acute cardiovascular events. It has been also known that the risk of acute cardiovascular events is reduced by bariatric surgery. However, little is known about whether bariatric surgery lowers the risk of acute cardiovascular events in patients with obesity and hypertrophic cardiomyopathy (HCM). In this context, we aimed to investigate whether bariatric surgery is associated with a reduced risk of cardiovascular‐related acute care use in patients with HCM. Methods and results In this population‐based study, the bariatric surgery group consisted of patients with HCM who underwent bariatric surgery from January 2004 to December 2014. The control group included those who have obesity and HCM and received non‐bariatric elective intra‐abdominal surgery during the same period. The outcome was cardiovascular‐related acute care use (i.e. emergency department (ED) visits or unplanned hospitalizations for cardiovascular disease) during a 1‐year post‐surgery period. We used the SPARCS database, a population‐based ED and inpatient database in New York State. We constructed logistic regression models with generalized estimating equations to compare the risk of the outcome events during sequential 6‐month post‐surgery periods. We adjusted for age, sex, number of ED visits and hospitalizations for cardiovascular disease within 2 years before the index surgery, and the Elixhauser co‐morbidity measures. We also performed propensity score (PS)‐matching and inverse probability treatment weighting analyses using these variables. The analytic cohort consisted of 207 adults with obesity and HCM, including 147 patients who underwent bariatric surgery and 60 in the control group. The risk was not significantly different in the 1–6 months post‐surgery period. By contrast, in the 7–12 months post‐surgery period, the risk of cardiovascular‐related acute care use was significantly lower in the bariatric surgery group (adjusted odds ratio 0.23; 95% CI 0.068–0.71; P = 0.01) compared with the control group. In the PS‐matched cohort, there were no significant differences in the baseline characteristics. The PS‐matched analysis demonstrated lower risk of the outcome event in the bariatric surgery group in the 7–12 months post‐surgery period. The inverse probability treatment weighting analysis replicated the findings. Conclusions Bariatric surgery was associated with a lower risk of cardiovascular‐related acute care use in the 7–12 months post‐surgery period in this population‐based study.https://doi.org/10.1002/ehf2.14414Bariatric surgeryCardiovascular diseaseHypertrophic cardiomyopathyObesity |
| spellingShingle | Satoshi Miyashita Keitaro Akita Yanling Zhao Kohei Hasegawa Mathew S. Maurer Shepard D. Weiner Muredach P. Reilly Hiroo Takayama Yuichi J. Shimada Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy ESC Heart Failure Bariatric surgery Cardiovascular disease Hypertrophic cardiomyopathy Obesity |
| title | Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy |
| title_full | Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy |
| title_fullStr | Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy |
| title_full_unstemmed | Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy |
| title_short | Effects of bariatric surgery on cardiovascular‐related acute care use in patients with hypertrophic cardiomyopathy |
| title_sort | effects of bariatric surgery on cardiovascular related acute care use in patients with hypertrophic cardiomyopathy |
| topic | Bariatric surgery Cardiovascular disease Hypertrophic cardiomyopathy Obesity |
| url | https://doi.org/10.1002/ehf2.14414 |
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