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Metabolic Surgery Linked to Reduced Risk for MACE After MI

Risk for death, new MI, heart failure lower with metabolic surgery in obese patients with previous MI

MONDAY, Oct. 26, 2020 (HealthDay News) — Metabolic surgery is associated with a reduced risk for major adverse cardiovascular events and death among patients with previous myocardial infarction (MI) and obesity, according to a study published online Oct. 26 in Circulation.

Erik Näslund, M.D., Ph.D., from Danderyd Hospital in Stockholm, and colleagues examined the association between metabolic surgery and major adverse cardiovascular events in patients with previous MI and severe obesity. Data were included for 509 patients who underwent metabolic surgery matched for sex, age, year of MI, and body mass index in a 1:1 ratio to controls with MI but with no metabolic surgery. Patients were followed for a median of 4.6 years.

The researchers observed a lower eight-year cumulative probability of major adverse cardiovascular events in patients undergoing versus not undergoing metabolic surgery (18.7 versus 36.2 percent; adjusted hazard ratio, 0.44). The risks for death and new MI were also significantly lower for patients undergoing metabolic surgery (hazard ratios, 0.45 and 0.24, respectively), as was new-onset heart failure, while no significant differences were seen regarding stroke and new-onset atrial fibrillation.

“This study suggests that metabolic surgery in severely obese patients with previous MI is associated with a low risk of serious complications and a substantially better cardiovascular long-term outcome compared with no surgery,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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