Risk Factors for Heart Attack Remain Low 7 Years After Gastric Bypass

Total cholesterol, triglycerides and C-reactive protein levels are among 11 risk factors for heart attack that remained greatly reduced up to seven years after gastric bypass surgery, according to a new Stanford University study presented at the 29th Annual Meeting of the American Society for Metabolic & Bariatric Surgery. Researchers say the study is the first to demonstrate a long-term and sustained cardiac benefit for patients after gastric bypass across so many risk factors.

“Patients significantly decreased their risk for having a heart attack within the first year of surgery and maintained that benefit over the long-term,” said lead study author John Morton, MD, an associate professor of surgery and director of bariatric surgery at Stanford Hospital & Clinics at Stanford University. Researchers also noted significant decreases in blood pressure and diabetes markers like fasting insulin and hemoglobin A1c.

Morton and colleagues studied 182 patients who had gastric bypass surgery and follow-up beyond three years at Stanford between 2003 and 2011. Patients were on average 44 years old, and had an average BMI of 47.

Study investigators analyzed changes to 11 cardiac risk factors that have been shown to increase the likelihood of future heart attacks or coronary artery disease. These markers included lipid and cholesterol levels, metabolic syndrome, homocysteine (amino acid) levels, Framingham Risk Score, and C-reactive protein levels, a measure of inflammation that Morton says may be the single most important predictor of future heart disease.

In up to seven years of follow-up, patients maintained a loss of about 56% of their excess weight, going from about 286 lbs, to about 205 lbs after surgery. Before surgery, nearly one-in-four patients were on statins, cholesterol lowering medications, which were discontinued shortly after surgery.

Patients saw a 40% increase in high-density lipoproteins, a 66% drop in fasting insulin levels and sharp drops in triglycerides, which were reduced by 55%.

C-reactive protein fell by 80% (10.9 to 2.6 mg/dL). The Framingham Risk Score, a composite predictive tool for future cardiac events, also decreased by nearly 40%.

“An 80% reduction in the C-reactive protein level is an astounding drop,” said Morton. “This is significantly better than what the best medical therapy has been shown to achieve and underscores the inflammatory nature of obesity, which can be reversed with surgical weight loss.”

Source: American Society for Metabolic & Bariatric Surgery

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