(HealthDay News) — For patients with type 2 diabetes and obesity, metabolic surgery is associated with a reduced risk for mortality and major adverse cardiovascular events, according to a study published online in the Journal of the American Medical Association to coincide with the European Society of Cardiology Congress 2019, held from Aug. 31 to Sept. 4 in Paris.

Ali Aminian, MD, from the Cleveland Clinic, and colleagues conducted a retrospective cohort study involving 2287 adults with diabetes and obesity who underwent metabolic surgery. These patients were matched with 11,435 nonsurgical control patients with diabetes and obesity.

The researchers found that at the end of the study period, 385 patients in the surgical group and 3243 in the nonsurgical group experienced a primary end point (first occurrence of the composite of all-cause mortality, coronary artery events, cerebrovascular events, heart failure, nephropathy, and atrial fibrillation; cumulative incidence at eight years, 30.8 vs 47.7%; adjusted hazard ratio, 0.61). Statistically significant differences were seen in favor of metabolic surgery in all 7 prespecified secondary outcomes including mortality. All-cause mortality occurred in 112 and 1111 patients in the metabolic surgery and nonsurgery groups, respectively (cumulative incidence at eight years, 10.0 and 17.8%, respectively; adjusted hazard ratio, 0.59).

“A well-designed randomized controlled trial is needed to definitively determine whether metabolic surgery can reduce the incidence of major heart problems in patients with type 2 diabetes and obesity,” a coauthor said in a statement.

References

Aminian A, Zajichek A, Arterburn DE, et al. Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity. JAMA. (Published online September 2, 2019.) doi:10.1001/jama.2019.14231

Livingston EH.  The Role of Bariatric Surgery in Managing the Macrovascular Complications of Obesity-Related Type 2 Diabetes. JAMA. (Published online September 2, 2019.) doi:10.1001/jama.2019.14577

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