Key result
Bariatric surgery resulted in a significantly greater reduction in high-sensitivity cardiac troponin I compared to intensive lifestyle intervention (OR 2.32; 95% CI 1.03-5.22; p=0.041).
Why the study?
Does Roux-en-Y gastric bypass reduce high-sensitivity cardiac troponin I levels compared to intensive lifestyle intervention in subjects with morbid obesity?
Does Roux-en-Y gastric bypass reduce high-sensitivity cardiac troponin I levels compared to intensive lifestyle intervention in subjects with morbid obesity?
Bariatric surgery is associated with a significantly greater reduction in subclinical myocardial injury (measured by hs-cTnI) compared to intensive lifestyle intervention in patients with morbid obesity.
Answers are grounded in this paper and cite their sources.
Bariatric surgery was associated with greater hs-cTnI reduction than lifestyle intervention in morbid obesity; leaves open whether this improves cardiovascular outcomes.
AIMS: To investigate the effect of weight loss induced by bariatric surgery and intensive lifestyle intervention on levels of circulating high-sensitivity cardiac troponin I. METHODS AND RESULTS: We measured high-sensitivity cardiac troponin I concentrations pre- and 12 months post-intervention in 136 subjects with morbid obesity participating in a controlled clinical trial comparing the effect of intensive lifestyle intervention vs. Roux-en-Y gastric bypass. At baseline median (interquartile range) high-sensitivity cardiac troponin I levels were 2.40 (1.28-3.95) ng/L in the bariatric surgery group and 2.35 (1.38-4.40) ng/L in the intensive lifestyle intervention group (p = 0.736). The high-sensitivity cardiac troponin I concentration in a normal-weight control group was 0.90 (0.60-2.13) ng/L. During 12 months of follow-up, high-sensitivity cardiac troponin I decreased significantly more in the bariatric surgery group than in the intensive lifestyle intervention group (0.80 (0-1.80) vs. 0.15 (-0.50 to 1.00) ng/L; p = 0.002). In a multivariate logistic regression model, surgery emerged as a predictor of reduction in high-sensitivity cardiac troponin I levels (odds ratio 2.32; 95% confidence intervals 1.03-5.22; p = 0.041) independent of age, gender and other possible confounding baseline variables. In subsequent multivariate analyses, reductions in body weight and triglycerides emerged as possible mediators of reduction in circulating levels of high-sensitivity cardiac troponin I. CONCLUSION: In patients with morbid obesity, bariatric surgery was associated with a significantly greater reduction in high-sensitivity cardiac troponin I, an index of subclinical myocardial injury, than intensive lifestyle intervention. The reduction appeared to be mediated by reductions in body weight and serum triglycerides. This suggests that weight loss following bariatric surgery may reduce cardiometabolic stress and subsequent risk of heart failure.
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Lyngbakken et al. (2015) studied Morbid obesity (n=136). Roux-en-Y gastric bypass vs. Intensive lifestyle intervention was evaluated on Reduction in high-sensitivity cardiac troponin I levels (OR 2.32, 95% CI 1.03-5.22, p=0.041). Bariatric surgery resulted in a significantly greater reduction in high-sensitivity cardiac troponin I compared to intensive lifestyle intervention (OR 2.32; 95% CI 1.03-5.22; p=0.041).
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