Bariatric Surgery and Long-term Cardiovascular Events

作者：Lars Sjöström, Markku Peltonen, Peter Jacobson, C. David Sjöström, Kristjan Karason, Hans Wedel, Sofie Ahlin, Åsa Anveden, Calle Bengtsson, Gerd Bergmark, Claude Bouchard, Björn Carlsson, S Dahlgren, Jan Karlsson, Anna‐Karin Lindroos, Hans Lönroth, Kristina Narbro, Ingmar Näslund, Torsten Olbers, Per‐Arne Svensson, Lena Carlsson · 发表于：JAMA · 年份：2012 · DOI：10.1001/jama.2011.1914 · 被引用次数：1646 · 研究领域：Bariatric Surgery and Outcomes、Cardiovascular Function and Risk Factors、Cardiovascular Disease and Adiposity

CONTEXT: Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking. OBJECTIVE: To study the association between bariatric surgery, weight loss, and cardiovascular events. DESIGN, SETTING, AND PARTICIPANTS: The Swedish Obese Subjects (SOS) study is an ongoing, nonrandomized, prospective, controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden of 2010 obese participants who underwent bariatric surgery and 2037 contemporaneously matched obese controls who received usual care. Patients were recruited between September 1, 1987, and January 31, 2001. Date of analysis was December 31, 2009, with median follow-up of 14.7 years (range, 0-20 years). Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women. Exclusion criteria were identical in surgery and control patients. Surgery patients underwent gastric bypass (13.2%), banding (18.7%), or vertical banded gastroplasty (68.1%), and controls received usual care in the Swedish primary health care system. Physical and biochemical examinations and database cross-checks were undertaken at preplanned intervals. MAIN OUTCOME MEASURES: The primary end point of the SOS study (total mortality) was published in 2007. Myocardial infarction and stroke were predefined secondary end points, considered separately and combined. RESULTS: Bariatric surgery was associate...