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Circulation:缩胃手术可降低重度肥胖患者的多种心血管不良结局风险

2021-04-18 Nebula MedSci原创

肥胖患者进行缩胃手术可降低多种心血管不良预后结局风险!

众所周知,肥胖、2型糖尿病(T2D)与血管疾病(CVD)之间存在一定关联。重度肥胖症合并心肌梗塞的患者数量持续增长,但目前仍缺乏科学证据提示应如何治疗这类患者。

本研究旨在在既往有心肌梗死(MI)史的重度肥胖患者中调查代谢性手术(Roux-en-Y胃搭桥术和袖状胃切除术)和主要不良心血管事件的相关性

在SWEDEHEART注册处注册的566名既往有MI史的接受了代谢性手术并在国家性Scandinavian肥胖手术注册处注册的患者在,有509位患者(465位接受了Roux-en-Y胃搭桥术,44位接受了袖状胃切除术)可与来自SWEDEHEART的作为对照的未进行代谢性手术的MI患者1:1匹配(性别、年龄、MI时间和体重指数)。

总体上,两组患者的匹配良好,但接受代谢性手术的患者的MI、既往心衰、房颤和慢性梗阻性肺疾病后射血分数降低的百分比更低(分别是7% vs 12%、10% vs 19%、6% vs 10%和4% vs 7%)

两组患者的MI和卒中预后

中位随访4.6年。接受代谢性手术的患者的主要不良心血管事件的8年累积发生风险明显低于对照组(18.7% vs 36.2%,校正风险比 0.44[95% CI 0.32-0.61])。此外,接受代谢性手术的患者的死亡风险(校正风险比 0.45)和新发心衰风险均更低,但卒中和新发房颤风险均无显著差异(校正风险比分别为0.91和0.56)。

综上所述,对于既往有过MI史的重度肥胖患者,代谢性手术可降低其重度并发症、主要不良心血管事件、死亡、新发MI和新发心衰的风险。该研究结果需要在随机对照试验中进一步验证。

原始出处:

Tomas Jernberg, et al. Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Previous Myocardial Infarction and Severe Obesity. Circulation. 2021;143:1458–1467

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    2021-04-19 ZJYYY7

    对于既往有过MI史的重度肥胖患者,代谢性手术可降低其重度并发症、主要不良心血管事件、死亡、新发MI和新发心衰的风险。

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