Aims: Obesity and diabetes are both risk factors for atrial fibrillation (AF) and heart failure (HF). Our aim was to study the effects of bariatric surgery on incidence of HF and AF in patients with type 2 diabetes (T2D) and obesity.
Methods: In this register-based nationwide cohort study we compared individuals with T2D and obesity that underwent Roux-en-Y gastric bypass surgery (GBP) between 2007 and 2013 with individuals with T2D that did not undergo surgery. Propensity score matching was performed on the basis of sex, age, BMI and calendar time. Data were gathered from the Swedish National Diabetes Register and Scandinavian Obesity Surgery Registry as well as other national databases for our main outcomes of hospitalization for HF and/or AF.
Results: We identified 5321 individuals with T2D that had undergone GBP and 5321 matched controls. Follow up was up to 9 years. Our results show a 44% lower risk for AF (HF 0.56, 0.42-0.75, p < 0.001), 71% for HF (HR 0.29, 0.21-041, p <0.001) and 75% lower risk for simultaneous diagnosis of AF and HF (HR 0.25, 0.13-0.29, p < 0.001) in the surgical group.
Conclusion: Our study suggests that bariatric surgery may substantially lower risk for HF and AF in patients with T2DM that undergo GBP as compared to patients who do not. These data reiterate importance of excess weight on such outcomes.
G. Höskuldsdottir: None. N. Sattar: Advisory Panel; Self; Amgen, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S, Pfizer Inc., Sanofi. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc. M. Miftaraj: None. I. Naslund: Consultant; Self; Baricol Bariatrics AB, Sweden, Ethicon,Johnson&Johnson A/S, Denmark. Other Relationship; Self; AstraZeneca. J.R. Ottosson: Advisory Panel; Self; Johnson & Johnson Medical Devices Companies. S. Franzén: None. A. Svensson: None. B. Eliasson: Consultant; Self; Amgen, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma International, Novo Nordisk A/S, Sanofi.