Abstract 9459: Bariatric Surgery Improves Mortality in Patients With Heart Failure

Abstract

Introduction: Bariatric surgery has been associated with decreased adverse cardiovascular outcomes. There is a paucity of data regarding long-term outcomes in patients with heart failure who underwent bariatric surgery. Hypothesis: Bariatric surgery is associated with better long-term outcomes in patients with heart failure and BMI≥40. Methods: Using ICD-10 codes, we identified patients with heart failure and BMI≥40 from 2016 to 2021 by using the TriNetx diamond network which includes data from ambulatory and primary care electronic medical records, medical claims from claims clearinghouses, and patient medication data from pharmacy claims around the USA. The patient population was divided in 2 groups, those who underwent a bariatric surgery procedure versus those who did not. Subgroup analysis of patients with systolic and diastolic heart failure was also performed. Propensity score matching was used to equilibrate for approximately 90 variables. The outcomes were measured from 3 months up to 5 years after the index event. Results: A total of 2,896 patients were included in each cohort, 63% were females. Patients with heart failure and BMI ≥ 40 kg/m2 that underwent bariatric surgery had approximately 67% lower likelihood of mortality (OR 0.336, P<0.0001), 50% lower incidence of atrial fibrillation (OR 0.504, P<0.0001), 45% less ventricular tachycardia (OR0.556, P0.0014), 43% less AMI (OR 0.578, P 0.0148), and 30% less cerebral ischemia (OR 0.708, P0.043). On subgroup analysis, similar outcomes were seen in patients with systolic heart failure except for cerebral ischemia which did not have a significant association. In patients with diastolic heart failure, only mortality and atrial fibrillation had lower incidences after bariatric surgery. Conclusions: Bariatric surgery is associated with decreased mortality and cardiovascular outcomes in patients with heart failure and BMI≥40. Prospective and/or randomized studies are required to prove these results.