AUTHOR=Yuan Hongtao , Medina-Inojosa Jose R. , Lopez-Jimenez Francisco , Miranda William R. , Collazo-Clavell Maria L. , Sarr Michael G. , Chamberlain Alanna M. , Hodge David O. , Bailey Kent R. , Wang Yutang , Chen Yundai , Cha Yong-Mei 

TITLE=The Long-Term Impact of Bariatric Surgery on Development of Atrial Fibrillation and Cardiovascular Events in Obese Patients: An Historical Cohort Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.647118

DOI=10.3389/fcvm.2021.647118

ISSN=2297-055X

ABSTRACT=Abstract
Objective: To determine whether early Roux-en-Y gastric bypass surgery (RYGB) reduces the risk of MACE in patients with obesity.
Patients and Methods: We conducted a study of patients with class II and III obesity (body mass index [BMI] >35 kg/m2) from Olmsted County, Minnesota, that underwent obesity clinic consultation between the years 1993-2012, and had either RYGB surgery within one year (RYGB-1Y group), or medically managed (No-RYGB group). The composite endpoint of MACE (all-cause mortality, stroke, heart failure admission and acute myocardial infarction) was the primary endpoint, with new-onset AF as the secondary endpoint. 
Results: Of the 1009 study patients, 308had RYGB-1Y and 701 were medically managed (No-RYGB). Overall, the age was 44.0±12.4 (mean±SD) years; BMI was 45.0±6.8 kg/m2. The RYGB-1Y group had a lower rate of MACE (adjusted hazard ratio (HR), 0.62;95% CI, 0.44-0.88;P=.008) and lower mortality (adjusted HR,0.51;95% CI, 0.26-0.96; P=.04) than the No-RYGB group. The RYGB-1Y surgery was not associated with lower AF occurrence (HR, 0.66; 95% CI, 0.40-1.10; P=.11).
Conclusion: An early RYGB approach for BMI reduction was associated with lower rates of MACE.