general surgery

The study find that weight loss surgeries in patients with obesity and type 2 diabetes could reduce the risk of death and major untoward heart or cardiovascular events or major adverse cardiovascular events (MACE). But This large study also reveals that persons undergoing these surgeries ;have a better diabetes control or blood glucose control and needed less medication for their diabetes control and heart health. Therefore The study titled; but “Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity” is publish in the September issue of the Journal of the American Medical Association ;(JAMA).

Weight loss surgeries in patients

Four in ten Americans suffer from diabetes and heart disease and research has shown that 40% of the patients with diabetes are at risk of dying due to heart disease and its complications. Therefore The research question the authors of the study posed was; “Is there an association between metabolic surgery and major adverse cardiovascular events (all-cause mortality; coronary artery events, cerebrovascular events, heart failure, nephropathy, and atrial fibrillation) ;in patients with type 2 diabetes and obesity?”

The team of researchers included 2,287 patients who underwent one of the four types of metabolic surgeries – gastric bypass; sleeve gastrectomy; adjustable gastric banding; or duodenal switch surgery. These patients are then compare to 11,435 match patients who did not undergo the surgeries but are provided standard medical care. Thus each of the participant who underwent surgery is match in a 1:5 ratio with a control. Because The study took place between 1998 and 2017. All participants were followed up until December 2018.

Types of metabolic surgeries

There were around 65% females in either group and the average age of the participants at recruitment was around 53 years. The data was obtained from the Cleveland Clinic Electronic Health Record (EHR). But The team was looking at deaths or any of the five major events associated with cardiovascular disease; obesity and diabetes among the participants. The five events they recorded as untoward were coronary artery events such as heart attacks or angina, cerebrovascular events such as strokes; heart failure, abnormal heart rhythm or atrial fibrillation or kidney disease.

The authors wrote describing their study population, “Metabolic surgical procedures included Roux-en-Y gastric bypass (n = 1443 [63%]); sleeve gastrectomy (n = 730 [32%]); adjustable gastric banding (n = 109 [5%]), and duodenal switch (n = 5). In the surgical group, 1713 patients (75%) had a BMI of 40 or greater; 465 patients (20%); had a BMI between 35 and 39.9; and 109 patients (5%); had a BMI between 30 and 34.9.” Results revealed that over a course of eight year of follow up of the patients and the controls; those that underwent the metabolic surgeries had a 40% lowered risk of getting one of the five adverse cardiovascular events compared to those who were on standard medical care.