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Bariatric Sx Cuts Macrovascular Complications in Obesity, T2DM

TUESDAY, Oct. 15, 2018 -- For patients with severe obesity and type 2 diabetes, bariatric surgery is associated with a lower risk for macrovascular outcomes compared with not undergoing surgery, according to a study published in the Oct. 16 issue of the Journal of the American Medical Association.

David P. Fisher, M.D., from the Permanente Medical Group in Oakland, Calif., and colleagues conducted a retrospective matched cohort study involving 5,301 patients (aged 19 to 79 years) with severe obesity and diabetes who underwent bariatric surgery from 2005 to 2011 and were matched to 14,934 control non-surgical patients.

The researchers identified 106 macrovascular events in surgical patients over a median of 4.7 years and 596 events in matched control patients over a median of 4.6 years. At five years, bariatric surgery correlated with a lower composite incidence of macrovascular events (2.1 versus 4.3 percent; hazard ratio, 0.60; 95 percent confidence interval, 0.42 to 0.86) and lower incidence of coronary artery disease (1.6 versus 2.8 percent; hazard ratio, 0.64; 95 percent confidence interval, 0.42 to 0.99). At five years, the incidence of cerebrovascular disease did not differ significantly between the groups (0.7 versus 1.7 percent; hazard ratio, 0.69; 95 percent confidence interval, 0.38 to 1.25).

"Health care professionals should engage patients with severe obesity and type 2 diabetes in a shared decision making conversation about the potential role of bariatric surgery in the prevention of macrovascular events," the authors write.

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Posted: October 2018