Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study
Abstract Aim We aim to assess the risk of heart failure in patients with obesity with and without gastric bypass surgery compared with population controls. Methods and results This cohort study included all patients aged 20–65 years with a first ever registered principal diagnosis of obesity in the...
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| Format: | Article |
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Wiley
2022-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13880 |
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| author | Christina E. Lundberg Shabbar Jamaly Martin Adiels Jesper Lagergren Carl Johan Svensson Lena Björck Annika Rosengren |
| author_facet | Christina E. Lundberg Shabbar Jamaly Martin Adiels Jesper Lagergren Carl Johan Svensson Lena Björck Annika Rosengren |
| author_sort | Christina E. Lundberg |
| collection | DOAJ |
| description | Abstract Aim We aim to assess the risk of heart failure in patients with obesity with and without gastric bypass surgery compared with population controls. Methods and results This cohort study included all patients aged 20–65 years with a first ever registered principal diagnosis of obesity in the Swedish Patient Register in 2001–2013. These patients were matched by age, sex, and region with two population controls from the general Swedish population without obesity diagnosis. The obesity cohort was divided into two groups: 27 882 patients who had undergone gastric bypass surgery within 2 years of obesity diagnosis and 39 564 patients who had not undergone such surgery. These groups were compared with 55 149 and 78 004 matched population controls, respectively. Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, education, and sex. During follow‐up (maximum 10 years, median 4.4 years, and interquartile range 2.5–7.2 years), 1884 participants were hospitalized for heart failure. Compared with population controls, gastric bypass patients had no excess risk of heart failure during the initial 0–≤4 years of follow‐up (HR = 1.35 [95% CI = 0.96–1.91]) but a marked increased risk during the final >4–10 years of follow‐up (HR = 3.28 [95% CI = 2.25–4.77]). Non‐operated patients with obesity had a marked excess risk of heart failure throughout the study period compared with population controls. Conclusions Gastric bypass for obesity seems to reduce the risk of heart failure to levels similar to the general population during the initial 4 years after surgery, but not thereafter. |
| format | Article |
| id | doaj-art-ca443f4a552f492eabe6fafcbdbc8206 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-ca443f4a552f492eabe6fafcbdbc82062025-02-05T05:22:10ZengWileyESC Heart Failure2055-58222022-06-01931844185210.1002/ehf2.13880Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort studyChristina E. Lundberg0Shabbar Jamaly1Martin Adiels2Jesper Lagergren3Carl Johan Svensson4Lena Björck5Annika Rosengren6Department of Molecular and Clinical Medicine, Sahlgrenska Academy University of Gothenburg Diagnosvägen 11 Gothenburg 41650 SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy University of Gothenburg Diagnosvägen 11 Gothenburg 41650 SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy University of Gothenburg Diagnosvägen 11 Gothenburg 41650 SwedenUpper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute Karolinska University Hospital Solna SwedenDepartment of Anesthesiology and Intensive Care Medicine, Region Västra Götaland Sahlgrenska University Hospital/Östra Gothenburg SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy University of Gothenburg Diagnosvägen 11 Gothenburg 41650 SwedenDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy University of Gothenburg Diagnosvägen 11 Gothenburg 41650 SwedenAbstract Aim We aim to assess the risk of heart failure in patients with obesity with and without gastric bypass surgery compared with population controls. Methods and results This cohort study included all patients aged 20–65 years with a first ever registered principal diagnosis of obesity in the Swedish Patient Register in 2001–2013. These patients were matched by age, sex, and region with two population controls from the general Swedish population without obesity diagnosis. The obesity cohort was divided into two groups: 27 882 patients who had undergone gastric bypass surgery within 2 years of obesity diagnosis and 39 564 patients who had not undergone such surgery. These groups were compared with 55 149 and 78 004 matched population controls, respectively. Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, education, and sex. During follow‐up (maximum 10 years, median 4.4 years, and interquartile range 2.5–7.2 years), 1884 participants were hospitalized for heart failure. Compared with population controls, gastric bypass patients had no excess risk of heart failure during the initial 0–≤4 years of follow‐up (HR = 1.35 [95% CI = 0.96–1.91]) but a marked increased risk during the final >4–10 years of follow‐up (HR = 3.28 [95% CI = 2.25–4.77]). Non‐operated patients with obesity had a marked excess risk of heart failure throughout the study period compared with population controls. Conclusions Gastric bypass for obesity seems to reduce the risk of heart failure to levels similar to the general population during the initial 4 years after surgery, but not thereafter.https://doi.org/10.1002/ehf2.13880ObesityGastric bypassHeart failureRisk factorsAtrial fibrillationMyocardial infarction |
| spellingShingle | Christina E. Lundberg Shabbar Jamaly Martin Adiels Jesper Lagergren Carl Johan Svensson Lena Björck Annika Rosengren Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study ESC Heart Failure Obesity Gastric bypass Heart failure Risk factors Atrial fibrillation Myocardial infarction |
| title | Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study |
| title_full | Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study |
| title_fullStr | Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study |
| title_full_unstemmed | Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study |
| title_short | Surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study |
| title_sort | surgical treatment of obesity and excess risk of developing heart failure in a controlled cohort study |
| topic | Obesity Gastric bypass Heart failure Risk factors Atrial fibrillation Myocardial infarction |
| url | https://doi.org/10.1002/ehf2.13880 |
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