Abstract | BACKGROUND: METHODS: This was a propensity score-matched cohort study using province-wide multiple-linked administrative databases in Ontario, Canada. Patients with previous ischemic heart disease or heart failure who received bariatric surgery were matched on age, sex, heart failure history, and a propensity score to similar controls from a primary care medical record database in a 1:1 ratio. The primary outcome was the incidence of extended MACE (first occurrence of all-cause mortality, myocardial infarction, coronary revascularization, cerebrovascular events, and heart failure hospitalization). Secondary outcome included 3-component MACE ( myocardial infarction, ischemic stroke, and all-cause mortality). Outcomes were evaluated through a combination of matching via propensity score and subsequent multivariable adjustment. RESULTS: A total of 2638 patients (n=1319 in each group) were included, with a median follow-up time of 4.6 years. The primary outcome occurred in 11.5% (151/1319) of the surgery group and 19.6% (259/1319) of the controls (adjusted hazard ratio [HR], 0.58 [95% CI, 0.48-0.71]; P<0.001). The association was notable for those with heart failure (HR, 0.44 [95% CI, 0.31-0.62]; P<0.001; absolute risk difference, 19.3% [95% CI, 12.0%-26.7%]) and in those with ischemic heart disease (HR, 0.60 [95% CI, 0.48-0.74]; P<0.001; absolute risk difference, 7.5% [95% CI, 4.7%-10.5%]). Surgery was also associated with a lower incidence of the secondary outcome (HR, 0.66 [95% CI, 0.52-0.84]; P=0.001) and cardiovascular mortality (HR, 0.35 [95% CI, 0.15-0.80]; P=0.001). CONCLUSIONS:
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Authors | Aristithes G Doumouras, Jorge A Wong, J Michael Paterson, Yung Lee, Branavan Sivapathasundaram, Jean-Eric Tarride, Lehana Thabane, Dennis Hong, Salim Yusuf, Mehran Anvari |
Journal | Circulation
(Circulation)
Vol. 143
Issue 15
Pg. 1468-1480
(04 13 2021)
ISSN: 1524-4539 [Electronic] United States |
PMID | 33813836
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Bariatric Surgery
(adverse effects)
- Cardiovascular Diseases
(etiology, physiopathology)
- Cohort Studies
- Female
- Humans
- Male
- Middle Aged
- Obesity
(complications)
- Propensity Score
- Retrospective Studies
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