Risk of Myocardial Infarction, Ischemic Stroke, and Mortality in Patients Who Undergo Gastric Bypass for Obesity Compared With Non-Operated Obese Patients and Population Controls.

• To estimate risks of myocardial infarction, ischemic stroke, and cardiovascular-related and all-cause mortality after Roux-en-Y gastric bypass (RYGB) for obesity compared with non-operated obese patients and matched non-obese population controls.Few studies have assessed the influence of RYGB on fatal and non-fatal myocardial infarction and ischemic stroke, and the results vary between studies.All patients aged 20-65years with obesity diagnosis in the nationwide Swedish Patient Registry in 2001-2013 were included. These participants were divided into those who underwent RYGB within 2years of obesity diagnosis (n=28,204) and non-operated (n=40,827), and were matched for age, sex, and region with two non-obese population controls. Participants were followed until onset of outcome disease, death, or end of follow-up. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (95% CI).Compared with non-operated patients with obesity, RYGB patients had a reduced risk of myocardial infarction (HR=0.44 [95% CI=0.28-0.63]), similar risk of ischemic stroke (HR=0.79 [95% CI=0.54-1.14]), and decreased risks of cardiovascular-related (HR=0.47 [95% CI=0.35-0.65]) and all-cause mortality (HR=0.66 [95% CI=0.54-0.81]) within the first 3years of follow-up, but not later. Compared with non-obese population controls, RYGB patients had excess risks of ischemic stroke (HR=1.57 [95% CI=1.08-2.29]), cardiovascular-related mortality (HR=1.82 [95% CI=1.29-2.60]), and all-cause mortality (HR=1.42 [95% CI=1.16-1.74]), but not of myocardial infarction (HR=1.02 [95% CI=0.72-1.46]).RYGB for obesity might not decrease the risk of ischemic stroke, but seems to decrease the risk of myocardial infarction back to population levels.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine (hsv//eng)

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