PMID- 33754795
OWN - NLM
STAT- MEDLINE
DCOM- 20211018
LR  - 20211018
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 10
IP  - 7
DP  - 2021 Apr 6
TI  - Potential Effects of Bariatric Surgery on the Incidence of Heart Failure and 
      Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus and Obesity and on 
      Mortality in Patients With Preexisting Heart Failure: A Nationwide, Matched, 
      Observational Cohort Study.
PG  - e019323
LID - 10.1161/JAHA.120.019323 [doi]
LID - e019323
AB  - Background Obesity and diabetes mellitus are strongly associated with heart 
      failure (HF) and atrial fibrillation (AF). The benefits of bariatric surgery on 
      cardiovascular outcomes are known in people with or without diabetes mellitus. 
      Surgical treatment of obesity might also reduce the incidence of HF and AF in 
      individuals with obesity and type 2 diabetes mellitus (T2DM). Methods and Results 
      In this register-based nationwide cohort study we compared individuals with T2DM 
      and obesity who underwent Roux-en-Y gastric bypass surgery with matched 
      individuals not treated with surgery. The main outcome measures were 
      hospitalization for HF and/or AF and mortality in patients with preexisting HF. 
      We identified 5321 individuals with T2DM and obesity who had undergone Roux-en-Y 
      gastric bypass surgery between January 2007 and December 2013 and 5321 matched 
      controls. The individuals included were 18 to 65 years old and had a body mass 
      index >27.5 kg/m(2). The follow-up time for hospitalization was until the end of 
      2015 (mean 4.5 years) and the end of 2016 for death. Our results show a 73% lower 
      risk for HF (hazard ratio [HR], 0.27; CI, 0.19-0.38), 41% for AF (HR, 0.59; CI, 
      0.44-0.78), and 77% for concomitant AF and HF (HR, 0.23; CI, 0.12-0.46) in the 
      surgically treated group. In patients with preexisting HF we observed 
      significantly lower mortality in the group who underwent surgery (HR, 0.23; 95% 
      CI, 0.12-0.43). Conclusions Bariatric surgery may reduce risk for HF and AF in 
      patients with T2DM and obesity, speculatively via positive cardiovascular and 
      renal effects. Obesity treatment with surgery may also be a valuable alternative 
      in selected patients with T2DM and HF.
FAU - Hoskuldsdottir, Gudrun
AU  - Hoskuldsdottir G
AD  - Department of Molecular and Clinical Medicine University of Gothenburg Sweden.
AD  - Department of Medicine Sahlgrenska University Hospital Gothenburg Sweden.
FAU - Sattar, Naveed
AU  - Sattar N
AD  - The Institute of Cardiovascular and Medical Sciences University of Glasgow United 
      Kingdom.
FAU - Miftaraj, Mervete
AU  - Miftaraj M
AD  - Centre of Registers National Diabetes Register Gothenburg Sweden.
FAU - Naslund, Ingmar
AU  - Naslund I
AD  - Department of Surgery Faculty of Medicine and Health Orebro University Orebro 
      Sweden.
FAU - Ottosson, Johan
AU  - Ottosson J
AD  - Department of Surgery Faculty of Medicine and Health Orebro University Orebro 
      Sweden.
FAU - Franzen, Stefan
AU  - Franzen S
AD  - Centre of Registers National Diabetes Register Gothenburg Sweden.
AD  - Health Metrics Unit Sahlgrenska AcademyUniversity of Gothenburg Sweden.
FAU - Svensson, Ann-Marie
AU  - Svensson AM
AD  - Department of Molecular and Clinical Medicine University of Gothenburg Sweden.
AD  - Centre of Registers National Diabetes Register Gothenburg Sweden.
FAU - Eliasson, Bjorn
AU  - Eliasson B
AD  - Department of Molecular and Clinical Medicine University of Gothenburg Sweden.
AD  - Department of Medicine Sahlgrenska University Hospital Gothenburg Sweden.
LA  - eng
GR  - RE/18/6/34217/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20210323
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
SB  - IM
MH  - Atrial Fibrillation/*epidemiology/etiology
MH  - Bariatric Surgery/*methods
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Female
MH  - Heart Failure/complications/*epidemiology
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications/*surgery
MH  - *Population Surveillance
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Survival Rate/trends
MH  - Sweden/epidemiology
PMC - PMC8174344
OTO - NOTNLM
OT  - atrial fibrillation
OT  - bariatric surgery
OT  - heart failure
OT  - obesity
OT  - type 2 diabetes mellitus
COIS- None.
EDAT- 2021/03/24 06:00
MHDA- 2021/10/21 06:00
PMCR- 2021/04/06
CRDT- 2021/03/23 12:18
PHST- 2021/03/24 06:00 [pubmed]
PHST- 2021/10/21 06:00 [medline]
PHST- 2021/03/23 12:18 [entrez]
PHST- 2021/04/06 00:00 [pmc-release]
AID - JAH36063 [pii]
AID - 10.1161/JAHA.120.019323 [doi]
PST - ppublish
SO  - J Am Heart Assoc. 2021 Apr 6;10(7):e019323. doi: 10.1161/JAHA.120.019323. Epub 
      2021 Mar 23.