Abstract 11987: Bariatric Surgery Reduces the Incidence of Heart Failure in Patients With Obesity

Abstract

Introduction: Obesity, and the related metabolic syndrome, is one of the largest public health challenges facing medical systems across the globe. A growing body of evidence supports using bariatric surgery in patients with obesity for weight loss and prevention of cardiovascular disease. However, relatively little research has considered whether bariatric surgery reduces the risk of heart failure. This propensity-score matched UK-wide retrospective study aims to answer that question. Hypothesis: We hypothesised that bariatric surgery would reduce the incidence of heart failure in patients with obesity, as compared to non-surgical management. Methods: Using the Clinical Practice Research Datalink, a study cohort containing 3,052 patients who had received bariatric surgery were matched by propensity score to 3,052 controls. The primary endpoint was development of any heart failure. The secondary endpoints were all-cause mortality, development of heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) specifically, and hospitalisations due to heart failure. These endpoints were assessed using a Cox proportional hazards model. Results: The mean follow-up duration was 7.50 years. Patients who received bariatric surgery had a significantly lower incidence of new heart failure (hazard ratio 0.45, 95% confidence interval 0.28-0.73, p=0.0011) and all-cause mortality (hazard ratio 0.56, 95% confidence interval 0.38-0.83, p=0.0036). There was no significant difference in the rates of HFrEF or HFpEF individually, though these analyses were notably underpowered. Conclusions: In conclusion, this UK retrospective study provides evidence of lower rates of heart failure and all-cause mortality in patients who have bariatric surgery when compared to propensity-score matched controls. Future efforts to understand the mechanism behind this reduction and explore the lifetime benefits in high risk cohorts are paramount.