News: Metabolic surgery associated with reducing major heart events for obese OSA patients

Among patients with obesity and obstructive sleep apnea (OSA), those who received metabolic surgery (also known as bariatric surgery) had a significantly lower cumulative risk of major adverse cardiovascular events (MACE) over a median follow-up of 5.3 years, according to a recent study published in the Journal of the American College of Cardiology. All-cause mortality, heart failure, and coronary artery events all showed lower rates for patients who had undergone metabolic surgery as well, MedPage Today reported.

The study used EHR data taken from the Cleveland Clinic Health System, and participants were adult patients who met criteria for both obesity (BMI of 35-70) and moderate-to-severe OSA. MACE was defined as first occurrence of coronary artery events (unstable angina, myocardial infarction, coronary intervention/surgery), cerebrovascular events (ischemic or hemorrhagic stroke, carotid intervention/surgery), heart failure, atrial fibrillation, and all-cause mortality.

Patients who received metabolic surgery lost an average of 33.2 kg (73.2 lb) after 10 years, while patients assigned to the nonsurgical control group lost 6.64 kg (14.6 lb). Average body weight was reduced by 24% and 4.7%, respectively. Also, in the smaller subset of patients who had been administered a repeat sleep study, those who received metabolic surgery had significant improvements in their OSA severity and hypoxemia.

The study “suggests the presence of a dose-dependent response between the amount of weight loss and cardiovascular benefits in patients with obstructive sleep apnea; the greater the weight loss, the lower the risk of heart complications,” study coauthor Ali Aminian, MD, also of the Cleveland Clinic, said in a statement. “With emergence of a new generation of obesity medications that can provide an average weight loss in the range of 15-20%, similar findings are theoretically possible from medical therapies.”

Editor’s note: To read MedPage Today’s coverage of this story, click here. To access the study, click here.