Abstract 15814: Reduction in 10-Year Framingham Risk of Cardiovascular Disease in Obese Patients Undergoing Laparoscopic Adjustable Gastric Banding
Introduction: Obesity is a major risk factor for cardiovascular disease (CVD). Weight loss has benefits for improving CVD risk factors, e.g., hypertension, diabetes, and dyslipidemia. Bariatric surgery guidelines include laparoscopic adjustable gastric banding (LAGB) for individuals with body mass index (BMI) ≥30; however, the clinical impact of the typical amount of weight loss following LAGB on estimated CVD risk is not well described. We examined whether LAGB-treated obese patients would have meaningful reductions in 10-year Framingham risk score (FRS) 12-15 months post-LAGB.
Methods: 2,389 obese patients (BMI≥30) aged 30-73 (Average age 46.4, 80% female) treated with LAGB were identified in the General Electric Centricity Electronic Medical Records (EMR) database, an observational health records U.S. database. 712 patients free of CVD at baseline, with measures of BMI, systolic blood pressure, diabetes and smoking status at baseline (pre-LAGB) and follow-up were eligible. The Framingham 10-year risk of developing CVD (coronary heart disease, stroke, transient ischemic attack, peripheral artery disease, heart failure) using office-based data including BMI was calculated pre- and 12-15 months post-LABG.
Results: Compared with baseline FRS, mean 10-year FRS decreased from 12.4% to 9.7% (p<.0001) 12-15 months post-LAGB (see table). Further, 35% were no longer obese. In the subset with lipid data available to calculate FRS (n=84) similar CVD risk reductions from 11.1% to 7.7% (p<.0001) were observed, with improvements in total (-17.3 mg/dL) and HDL (+10.5 mg/dL) cholesterol (p<.01). The greatest CVD risk reductions were seen in those with higher baseline BMI and in men.
Conclusions: Our data from a large U.S. EMR show that persons undergoing LAGB have significant weight loss and a reduced 10-year estimated CVD risk 12-15 months post-LAGB. Longer-term studies are needed to demonstrate whether there is a subsequent benefit on CVD events and mortality.
- © 2011 by American Heart Association, Inc.