Sweden: Bariatric surgery may reduce the risk of atrial fibrillation (AF) and heart failure in adults with type 2 diabetes (T2D) and obesity, finds a recent study in the Journal of the American Heart Association. The results suggest that bariatric surgery may be a beneficial treatment modality in patients with T2D and obesity.
Diabetes and obesity are strongly associated with atrial fibrillation and heart failure. The benefits of bariatric surgery on cardiovascular outcomes are known in people with or without diabetes mellitus. Treatment of obesity through surgery might also reduce HF and AF incidence in people with T2D and obesity. Gudrún Höskuldsdóttir, Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden, and colleagues aimed to compare individuals with T2DM and obesity who underwent Roux‐en‐Y gastric bypass surgery with matched individuals not treated with surgery in this register‐based nationwide cohort study.
The main outcome measures were hospitalized for AF and/or HF and mortality in patients with preexisting HF, The researchers identified 5321 individuals with T2D and obesity who had undergone Roux‐en‐Y gastric bypass surgery between January 2007 and December 2013 and 5321 matched controls. Included people were aged 18 to 65 years and had a body mass index >27.5 kg/m2. The follow‐up time for hospitalization was until the end of 2015 (mean 4.5 years) and the end of 2016 for death.
Key findings of the study include:
The results showed a 73% lower risk for HF (hazard ratio [HR], 0.27), 41% for AF (HR, 0.59), and 77% for concomitant AF and HF (HR, 0.23) in the surgically treated group.
In patients with preexisting HF we observed significantly lower mortality in the group who underwent surgery (HR, 0.23).
"The results of our study further strengthen earlier recommendations that bariatric surgery should be considered as a treatment option for individuals with T2DM and obesity. Surgery might even be considered in certain subgroups with known HF, a provocative but important suggestion because of the existence and complexity of the obesity paradox in HF," wrote the authors.
"Further studies are needed on effects of bariatric surgery on subtypes of HF as well as studies comparing surgical treatment with newer pharmaceutical treatment for T2DM," they concluded.
Reference:
The study titled, "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," is published in the Journal of the American Heart Association.
DOI: https://www.ahajournals.org/doi/10.1161/JAHA.120.019323