Alyssa Bellini, MS, Cristian A Milla Matute, MD, Maria C Fonseca Mora, MD, Joel S Frieder, MD, David A Gutierrez Blanco, MD, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Samuel Szomstein, MD, FACS, FASMBS, Raul J Rosenthal, MD, FACS, FASMBS. Cleveland Clinic Florida
INTRODUCTION: Heart disease is responsible for 610,000 annual deaths in the United States and is the principal cause of death among all ethnic groups. Risk factors for heart disease include high blood pressure, high cholesterol, tobacco and obesity. There is a paucity of data regarding ethnicity role in bariatric surgery outcomes. The aim of our study is to analyze if ethnicity plays a significant role on bariatric population outcomes, specifically heart age and cardiovascular risk score.
METHODS: Under IRB approval we performed a retrospective chart review of patients that underwent bariatric surgery from 2010 to 2015. We included patients from all ethnicities and analyzed demographics, comorbidities, heart age and cardiovascular risk score at time of procedure and at 12 months follow up. Ethnicities categorized were Asians, Caucasians, African American, and Multicultural. We calculated the heart age using the Framingham Study Heart Age Calculator and cardiovascular risk score using the ASCVD Risk Calculator from the 2013 ACC/AHA Guideline. SPSS software was used to perform Student's T-Test for mean analysis and Chi-Square for categorical variables.
RESULTS: From 1400 patients analyzed from 2010-2015, A total of 299 had all the variables needed to calculate the heart age and cardiovascular risk score. This patient population was composed of (83.28%) 249 Caucasians, (14.38%) 43 African American, and (2.34%) 7 Multicultural. Predominant gender was female (67.56%) 202 patients and mean age of 52.63±10.79 y. LSG was the predominant procedure with (73.58%)220 patients. Mean BMI pre-operatively versus post-operatively by ethnicity was 41.46±4.66 vs 30.08±4.34 Caucasians, 41.90±4.69 vs 32.08±4.68 for African Americans, and 38.60±2.72 vs 27.62±4.51 for multicultural. Mean heart age pre-operatively versus post-operatively by ethnicity was 71.35±14.59 vs 62.45±16.12 (p<0.0001) for Caucasians, 71.38±14.30 vs 65.91±16.61 (p=0.11) for African Americans, and 54.34±7.09 vs 43.42±6.96 (p=0.01) for Multicultural. Mean cardiovascular risk score pre-operatively versus post-operatively by ethnicity was 0.24±0.20 vs 0.15±0.14 (p<0.0001) for Caucasians, 0.20±0.19 vs 0.16±0.17 (p=0.23) for African Americans, and 0.062±0.024 vs 0.035±0.017 (p=0.03) for Multicultural patients. There was a significant reduction in diabetes preoperatively versus post-operatively in Caucasian patients 38.15% vs 20.08% (p<0.0001) but not in African Americans 51.16% vs 37.21% (p=0.19) or multicultural 14.21% vs 0%.
CONCLUSIONS: Ethnicity does not seem to impact weight loss after bariatric surgery. However, we found a significant difference in the reduction of heart age and cardiovascular risk reduction in the different ethnic categories studied. Further prospective and larger studies are needed to better understanding of these findings.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95271
Program Number: S117
Presentation Session: Bariatric IV – Quality and Outcomes
Presentation Type: Podium