Obesity surgery and incidence of heart failure

Abstract

Purpose: The purpose of the present study was to investigate the incidence of heart failure during long-term follow-up after surgical obesity treatment. Methods: The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects, of whom 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (control group). Patients were recruited between September 1, 1987 and January 31, 2001. Surgery patients underwent gastric bypass (13.2%), banding (18.7%), or vertical banded gastroplasty (68.1%), and controls received usual care in the Swedish primary health care system. The incidence of first-time diagnosed heart failure during hospitalisation was obtained by crosschecking the SOS database with the Swedish National Patient Register. Results: At December 31, 2009, the median follow-up of subjects in the SOS study was 14.7 years (range, 0-20 years). The mean changes in body weight after 2, 10, 15, and 20 years were −23%, −17%, −16%, and −18% in the surgery group and 0%, 1%, −1%, and −1% in the control group. Heart failure diagnosed for the first time during hospitalisation occurred in 91 (4,5%) patients in the surgery group and in 152 (7,5%) patients in the control group. The hazard ratio (unadjusted) for patients treated with bariatric surgery was 0.58 (95% CI: 0.45-0.75; p<0.001) and after adjustment for sex, age, and cardiovascular risk factors 0.52 (95% CI: 0.39-0.69; p<0.001). Conclusions: In obese patients treated with bariatric surgery, the risk for developing heart failure during long-term follow-up was almost halved, as compared with those receiving usual care.