David Gutierrez Blanco, MD, David Romero Funes, MD, SriGita Madiraju, MS, FAU, Federico Perez Quirante, MD, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Samuel Szomstein, MD, FACS, FASMBS, Raul Rosenthla, MD, FACS, FASMBS. Cleveland Clinic Florida
INTRODUCTION: Obesity has become a primary concern in public health. There is vast evidence that supports the importance of obesity in the pathogenesis and progression of cardiovascular disease. Our goal in this study is to determine the impact of bariatric surgery in the Framingham 10-year risk score.
METHODS: From our bariatric population we retrospectively reviewed all bariatric surgeries between 2010 and 2014. Patients that met the criteria for calculating the Framingham BMI 10 year risk score were included. Data collected included baseline demographics, perioperative parameters such as tobacco use, diagnosis of diabetes, treatment for hypertension, BMI and postoperative outcomes at 3 and 12 months.
RESULTS: From our 1129 bariatric patients, 358 (31.7%) patients met the criteria for the Framingham BMI 10 year risk score calculation. Laparoscopic sleeve gastrectomy (LSG) was the most prevalent surgery 61.45% (N=220) followed by laparoscopic Roux-en-Y gastric bypass 22% (N=79). Females composed 69% (N=248) of our population. The average age for female was 52.3±10.8 years and for male 54.07±11.2 years. The initial BMI was 40.57kg/m2 ±5.19 for females and 41.13 kg/m2 ±5.75 for males. The percentage of estimated BMI loss (%EBMIL) at 1 year was 64.43% in females and 60.69% in males. The initial Framingham 10-year score risk was significantly higher in males compared with females (36.16% ± 22.3 vs. 16.97%±15.6). After 12 months follow-up the absolute risk reduction in males was 11.58% and 6.17% in females in (P<0.001). Heart age was also calculated, the preoperative heart age was also significantly higher in males. After 12 months follow up the heart age reduced significantly; 7.88 years in females and 20.55 years in males. Absolute risk reduction was found to be most significant in LSG and LRYGB (p<0.001), compared to revision procedures (P=0.037) and laparoscopic gastric banding (p=0.09). After 1 year follow-up, treatment for hypertension was discontinued in 33% of the patients (p<0.001) and the complete resolution of diabetes mellitus was achieved in 38% of the patients (p<0.001).
CONCLUSION: Bariatric surgery has demonstrated to be effective method as treatment for obesity. Our results suggest that there is a positive correlation between a bariatric surgery and the reduction of the 10-year cardiovascular disease risk. Further prospective studies may be needed to better assess this correlation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80128
Program Number: S019
Presentation Session: Bariatric and Metabolic Surgery
Presentation Type: Podium