Metabolic Surgery May Reduce CV Risk in T2DM With Obesity

For patients with type 2 diabetes and obesity, metabolic surgery is associated with a reduced risk for mortality and major adverse cardiovascular events, according to a study published online Sept. 2 in the Journal of the American Medical Association.

Ali Aminian, M.D., from the Cleveland Clinic, and colleagues conducted a retrospective cohort study involving 2,287 adults with diabetes and obesity who underwent metabolic surgery. These patients were matched with 11,435 nonsurgical control patients with diabetes and obesity.

The researchers found that at the end of the study period, 385 patients in the surgical group and 3,243 in the nonsurgical group experienced a primary end point (first occurrence of the composite of all-cause mortality, coronary artery events, cerebrovascular events, heart failure, nephropathy, and atrial fibrillation; cumulative incidence at eight years, 30.8 versus 47.7 percent; adjusted hazard ratio, 0.61). Statistically significant differences were seen in favor of metabolic surgery in all seven prespecified secondary outcomes including mortality. All-cause mortality occurred in 112 and 1,111 patients in the metabolic surgery and nonsurgery groups, respectively (cumulative incidence at eight years, 10.0 and 17.8 percent, respectively; adjusted hazard ratio, 0.59).

"A well-designed randomized controlled trial is needed to definitively determine whether metabolic surgery can reduce the incidence of major heart problems in patients with type 2 diabetes and obesity," a coauthor said in a statement.

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