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Impact of bariatric surgery on carotid intima-medial thickness and cardiovascular risk: results of a prospective study

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Abstract

Background

The impact of bariatric surgery on atherosclerosis is a relatively less studied subject. Obesity has been identified as an independent risk factor for cardiovascular disease (CVD). Carotid intima-media thickness (CIMT), a surrogate marker for atherosclerosis and risk of CVD, has been found to be associated with obesity. Recent literature has shown that there is significant reduction in CIMT following bariatric surgery. The aim of this study was to evaluate the impact of bariatric surgery on CIMT and risk of CVD in an Indian population.

Methods

This is a prospective study conducted in a tertiary referral centre in India. Patients undergoing bariatric surgery from December 2017 to September 2019 were included. CIMT measurements and American College of Cardiology/American Heart Association (ACC/AHA)-pooled cohort CVD risk scores were done before and at 6 months and 12 months after surgery.

Results

Fifty-four patients were enrolled, of which 70% were females. Mean age was 40.8 ± 10.7 years. Mean pre-operative weight and mean BMI were 115.2 ± 21.9 kg and 45.9 ± 6.5 kg/m2, respectively. Patients who completed 12-month follow-up were considered for analysis of outcomes. There was significant reduction in BMI to 33.1 ± 5.7 kg/m2 at 12 months after surgery (p < 0.0001). Mean CIMT reduced significantly from 0.58 ± 0.08 mm at baseline to 0.52 ± 0.10 mm at 12 months. Lipid profile, fasting blood sugar and HbA1C also improved, which resulted in reduction of lifetime and 10-year CVD risk from 42.3 to 26% and 4 to 1.5%, respectively, at 12 months after surgery.

Conclusions

Bariatric surgery results in significant reduction in CIMT and CVD risk in patients with morbid obesity.

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Acknowledgements

The authors are grateful to Mr. Vishwajeet Singh, Research Officer, Department of Biostatistics, All India Institute of Medical Sciences, New Delhi for his valuable contribution in statistical analysis.

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Authors and Affiliations

  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, 110029, India

    Aashir Kaul, Arun Kumar, Aditya Baksi, Vitish Singla & Sandeep Aggarwal

  2. Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, India

    Gurpreet Gulati

  3. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

    Rajiv Narang

  4. Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India

    Lokesh Kashyap

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  1. Aashir Kaul
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Correspondence to Sandeep Aggarwal.

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Disclosures

Aashir Kaul, Arun Kumar, Aditya Baksi, Vitish Singla, Sandeep Aggarwal, Gurpreet Gulati, Rajiv Narang and Lokesh Kashyap have no conflict of interest or financial ties to disclose.

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Kaul, A., Kumar, A., Baksi, A. et al. Impact of bariatric surgery on carotid intima-medial thickness and cardiovascular risk: results of a prospective study. Surg Endosc 35, 6006–6012 (2021). https://doi.org/10.1007/s00464-020-08088-0

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