Bariatric Surgery Linked to Improved Outcomes After Myocardial Infarction

Roberto Simons-Linares, MD

New findings suggest patients with obesity who underwent bariatric surgery had improved outcomes when hospitalized with myocardial infarction, as data show lower inpatient mortality and lower rates of multi-organ failure.

“Bariatric Surgery improves outcomes of [myocardial infarction] and should be considered life-saving for patients with obesity who have a risk for cardiovascular disease,” wrote study author Roberto Simons-Linares, MD, Cleveland Clinic.

These findings were presented at the 2022 Digestive Disease Week Annual Meeting in San Diego, California.

Simons-Linares and colleagues investigated the inpatient mortality of those with obesity hospitalized with MI and compared those with a history of bariatric surgery, versus no history. They conducted a case-control study with a patient population obtained from the 2016 and 2017 National Inpatient Sample (NIS). Investigators used ICD10-CM and PCS code to identify patients with obesity hospitalized with MI and individuals with a history of bariatric surgery.

They explained primary outcomes as the differences in mortality rate and rates of inpatient outcomes and complications between patients with bariatric surgery and then those without, considered the control cohort. These were followed by secondary outcomes of organ failure, including acute kidney injury (AKI), respiratory failure requiring mechanical ventilation, shock, sepsis, and length of stay. Investigators constructed multivariate regression models to adjust for confounders and hospital characteristics.

A total of 290,450 (weighted) hospitalizations were included in the study. From this population, 3,805 had a history of bariatric surgery. Data show inpatient mortality rates were lower in patients with history of bariatric surgery (0.8% vs 2.3%; P = .001).

They additionally observed bariatric surgery was a protective factor, having lower odds of inpatient mortality after MI (odds ratio [OR], 0.34; 95% CI, 0.15 - 0.76; P = .01). When adjusting for multiple comorbidities and baseline characteristics between each group, bariatric surgery still had a protective effect (adjusted OR, 0.44; 95% CI, 0.19 - 0.98; P = .04).

Then, investigators noted bariatric surgery patients had lower rates of respiratory failure requiring mechanical ventilation (OR, 0.52; P = .01), AKI (OR, 0.59; P <.01), and shorter length of stay (OR, 0.51; P <.01).

The study, “Bariatric Surgery Decreases Mortality When Hospitalized With Myocardial Infarction,” was presented at DDW 2022.