Bariatric surgery was associated with a reduced risk of first-time heart failure compared with usual care among obese individuals (HR 0.65; 95% CI 0.54-0.79; P<0.001).
Cohort (n=4,033)
Does bariatric surgery reduce the risk of first-time heart failure in obese individuals compared to usual care?
Bariatric surgery is associated with a significantly reduced long-term risk of incident heart failure in obese individuals compared to usual care.
Hazard Ratio: 0.65 (95% CI 0.54–0.79)
Absolute Event Rate: 9.4% vs 13.1%
p-value: p=< 0.001
AIMS: Obesity is associated with increased risk for heart failure. We analysed data from the Swedish Obese Subjects (SOS) study, a prospective matched cohort study, to investigate whether bariatric surgery reduces this risk. METHODS AND RESULTS: From the total SOS population (n = 4047), we identified 4033 obese individuals with no history of heart failure at baseline, of whom 2003 underwent bariatric surgery (surgery group) and 2030 received usual care (control group). First-time principal diagnoses of heart failure were identified by crosschecking the SOS database with the Swedish National Patient Register and the Swedish Cause of Death Register using diagnosis codes. During a median follow-up of 22 years, first-time heart failure occurred in 188 of the participants treated with surgery and in 266 of those receiving usual care. The risk of developing heart failure was lower in the surgery group than in the control group sub-hazard ratio 0.65, 95% confidence interval (CI) 0.54-0.79; P < 0.001. After pooling data from the two study groups, the quartile of subjects with the largest weight loss after 1 year (mean -41 kg) displayed the greatest risk reduction (sub-hazard ratio 0.51, 95% CI 0.30-0.70; P < 0.001). This association remained statistically significant after adjustment for surgical intervention and potential baseline confounders (sub-hazard ratio 0.60, 95% CI 0.36-0.97; P = 0.038). CONCLUSION: Compared with usual care, bariatric surgery was associated with reduced risk of heart failure among persons being treated for obesity. The risk of heart failure appeared to decline in parallel with a greater degree of weight loss. CLINICALTRIALS.GOV IDENTIFIER: NCT01479452.
Jamaly et al. (2019) conducted a cohort in Obesity (n=4,033). Bariatric surgery vs. Usual care was evaluated on First-time principal diagnoses of heart failure (HR 0.65, 95% CI 0.54-0.79, p=< 0.001). Bariatric surgery was associated with a reduced risk of first-time heart failure compared with usual care among obese individuals (HR 0.65; 95% CI 0.54-0.79; P<0.001).