Y J Shimada1, T Goto2, Y Tsugawa3, E W Yu4, K Yoshida5, S Homma6, D F M Brown7, K Hasegawa7. 1. Division of Cardiology, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, PH 3-342, 10032 New York, USA. Electronic address: ys3053@cumc.columbia.edu. 2. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street, Suite 920, Boston, MA, USA; Graduate School of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji, Yoshida, Fukui, Japan. 3. Division of General Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, USA. 4. Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Their 1051, Boston, MA, USA. 5. Department of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, USA. 6. Division of Cardiology, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, PH 3-342, 10032 New York, USA. 7. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street, Suite 920, Boston, MA, USA.
Abstract
BACKGROUND AND AIMS: Gastric bypass is known to have larger effects on weight and metabolism than gastric banding. However, scarce data exist as to whether the differences are translated into differential risks of cardiovascular disease (CVD)-related morbidities. The objective was to examine whether adults with obesity and CVD who underwent gastric bypass have a lower rate of acute care use (emergency department [ED] visit or unplanned hospitalization) for CVD than those with gastric banding. METHODS AND RESULTS: We performed a comparative effectiveness study of gastric bypass versus banding among adults with obesity and CVD who underwent either surgery, using population-based [ED] and inpatient samples in California, Florida, and Nebraska from 2005 through 2011. The primary outcome was acute care use for CVD during a two-year postoperative period. We constructed negative binomial regression models to compare the event rate during sequential 6-month periods, using gastric banding group as the reference. We identified 11,229 adults with obesity and CVD who underwent gastric bypass and 3896 adults who had gastric banding. Patients with gastric bypass had significantly lower rate of the outcome compared to those with banding in the 7-12 months postoperative period (adjusted rate ratio [aRR] 0.77; 95% confidence interval [CI], 0.61-0.98; P = 0.03). The significant reduction in the rate persisted during 13-18 months (aRR 0.71; 95% CI, 0.57-0.90; P = 0.005) and 19-24 months (aRR 0.66; 95% CI, 0.52-0.82; P < 0.001) after bariatric surgery. CONCLUSION: In this population-based comparative effectiveness study of adults with obesity and CVD, the rate of acute care use for CVD was lower after gastric bypass compared to gastric banding.
BACKGROUND AND AIMS: Gastric bypass is known to have larger effects on weight and metabolism than gastric banding. However, scarce data exist as to whether the differences are translated into differential risks of cardiovascular disease (CVD)-related morbidities. The objective was to examine whether adults with obesity and CVD who underwent gastric bypass have a lower rate of acute care use (emergency department [ED] visit or unplanned hospitalization) for CVD than those with gastric banding. METHODS AND RESULTS: We performed a comparative effectiveness study of gastric bypass versus banding among adults with obesity and CVD who underwent either surgery, using population-based [ED] and inpatient samples in California, Florida, and Nebraska from 2005 through 2011. The primary outcome was acute care use for CVD during a two-year postoperative period. We constructed negative binomial regression models to compare the event rate during sequential 6-month periods, using gastric banding group as the reference. We identified 11,229 adults with obesity and CVD who underwent gastric bypass and 3896 adults who had gastric banding. Patients with gastric bypass had significantly lower rate of the outcome compared to those with banding in the 7-12 months postoperative period (adjusted rate ratio [aRR] 0.77; 95% confidence interval [CI], 0.61-0.98; P = 0.03). The significant reduction in the rate persisted during 13-18 months (aRR 0.71; 95% CI, 0.57-0.90; P = 0.005) and 19-24 months (aRR 0.66; 95% CI, 0.52-0.82; P < 0.001) after bariatric surgery. CONCLUSION: In this population-based comparative effectiveness study of adults with obesity and CVD, the rate of acute care use for CVD was lower after gastric bypass compared to gastric banding.
Authors: Jane S Saczynski; Susan E Andrade; Leslie R Harrold; Jennifer Tjia; Sarah L Cutrona; Katherine S Dodd; Robert J Goldberg; Jerry H Gurwitz Journal: Pharmacoepidemiol Drug Saf Date: 2012-01 Impact factor: 2.890
Authors: Doron Aronson; Inon Roterman; Mordechay Yigla; Arthur Kerner; Ophir Avizohar; Ron Sella; Peter Bartha; Yishai Levy; Walter Markiewicz Journal: Am J Respir Crit Care Med Date: 2006-06-15 Impact factor: 21.405
Authors: Lewis B Morgenstern; Melinda A Smith; Brisa N Sánchez; Devin L Brown; Darin B Zahuranec; Nelda Garcia; Kevin A Kerber; Lesli E Skolarus; William J Meurer; James F Burke; Eric E Adelman; Jonggyu Baek; Lynda D Lisabeth Journal: Ann Neurol Date: 2013-08-13 Impact factor: 10.422
Authors: Sayeed Ikramuddin; Judith Korner; Wei-Jei Lee; John E Connett; William B Inabnet; Charles J Billington; Avis J Thomas; Daniel B Leslie; Keong Chong; Robert W Jeffery; Leaque Ahmed; Adrian Vella; Lee-Ming Chuang; Marc Bessler; Michael G Sarr; James M Swain; Patricia Laqua; Michael D Jensen; John P Bantle Journal: JAMA Date: 2013-06-05 Impact factor: 56.272
Authors: Candace D McNaughton; Wesley H Self; Yuwei Zhu; Alexander T Janke; Alan B Storrow; Phillip Levy Journal: Am J Cardiol Date: 2015-09-10 Impact factor: 2.778