Obese heart failure patients may benefit from bariatric surgery

Patients who were obese and underwent bariatric surgery saw a significant reduction in heart failure-related exacerbation events.

Obese patients with heart failure who had bariatric surgery had a significant reduction in the incidence of heart failure exacerbation, according to research published in the Journal of the American College of Cardiology.

A team of researchers at the Massachusetts General Hospital conducted a self-controlled case series study using a population-based emergency department and inpatient sample from facilities across the country, focusing on obese patients with heart failure who underwent bariatric surgery between 2007 and 2009.

Of the 524 patients identified during the initial reference period, 16.2% visited the emergency department or were hospitalized for heart failure exacerbation. During the 12-month pre-surgery period, the researchers found that this rate remained relatively unchanged. During the first 12-month period post-surgery, patients who underwent bariatric surgery had a somewhat reduced rate of exacerbation-related events (12%); between 13 and 24 months, patients had significantly lower exacerbation-related events (9.9%).

“Our findings indicate that bariatric surgery is associated with a decline in the rate of heart failure exacerbation requiring [emergency department] evaluation or hospitalization among obese patients with heart failure,” wrote lead author Yuichi J. Shimada, MD, MPH, of the Cardiology Division at Massachusetts General Hospital and Harvard Medical School.

“Some patients have other health problems that make the risks of surgery higher,” Dr Shimada continued. “In those cases, accurate assessment of the risks and benefits of surgery becomes critically important. It also will be essential to develop effective nonsurgical options to help such patients achieve substantial and sustained weight loss.”