Association between bariatric surgery and rate of hospitalisations for stable angina pectoris in obese adults

Heart. 2017 Jul;103(13):1009-1014. doi: 10.1136/heartjnl-2016-310757. Epub 2017 Feb 16.

Abstract

Objective: Obesity and stable angina pectoris (SAP) are important public health problems in the USA. However, little is known about whether weight reduction affects the rate of SAP-related morbidities. This study was designed to test the hypothesis that bariatric surgery is associated with a lower rate of hospitalisations for SAP in obese adults.

Methods: We performed a self-controlled case series study of obese adults with SAP who underwent bariatric surgery using a population-based inpatient database in three states (California, Florida and Nebraska) from 2005 to 2011. The primary outcome was hospitalisation for SAP. We used conditional logistic regression to compare the rate of the outcome event during sequential 12-month periods, using presurgery months 13-24 as a reference period.

Results: Our sample consisted of 953 patients with SAP who underwent bariatric surgery. The median age was 57 years, 51% were women, and 78% were non-Hispanic white. During the reference period, 25.3% (95%CI, 22.5% to 28.1%) had a hospitalisation for SAP. The rate remained stable in the subsequent 12-month presurgery period (adjusted OR (aOR) 0.84 (95% CI, 0.69 to 1.02); p=0.07). In the first 12-month period after bariatric surgery, we observed a significantly lower rate (9.1% (95% CI, 7.3% to 11.0%); aOR 0.33 (95% CI, 0.26 to 0.43); p<0.0001). Similarly, the rate remained significantly lower in the subsequent 13-24 months after bariatric surgery (8.7% (95% CI, 6.9% to 10.5%); aOR 0.31 (95% CI, 0.24 to 0.41); p<0.0001).

Conclusion: In this population-based study of obese adults with SAP, we found that the rate of hospitalisations for SAP was lower by two-thirds after bariatric surgery.

Keywords: Coronary artery disease; Obesity heart disease; hronic coronary disease.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angina Pectoris / complications
  • Angina Pectoris / epidemiology
  • Angina Pectoris / therapy*
  • Bariatric Surgery*
  • Female
  • Follow-Up Studies
  • Hospitalization / trends*
  • Humans
  • Male
  • Middle Aged
  • Morbidity / trends
  • Obesity / complications
  • Obesity / surgery*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • United States / epidemiology