title: Long-term cardiovascular risk and coronary events in morbidly obese patients treated with laparoscopic gastric banding.
abstract: BACKGROUND
  Long-term studies reporting the effects of bariatric surgery on cardiovascular risk factors and events are scarce. The aim of this study was to analyze reduction of multiple cardiovascular risk factors and rates of coronary events in morbidly obese patients treated with bariatric surgery and with>10 years of follow-up.
  
  
  METHODS
  This was a prospective uncontrolled study with laparoscopic adjustable gastric banding. Cardiovascular risk factors (fasting glucose, total cholesterol, HDL-C, triglycerides, blood pressure) have been previously determined both at surgery and 12-18 months after in 650 patients treated with laparoscopic adjustable gastric banding from 1993 to 1999. Cardiovascular risk status was again determined in 2010, and the rate of coronary events during long-term (>10 years) follow-up was collected.
  
  
  RESULTS
  A total of 318 patients (58 men and 260 women) were retrieved. Age at surgery was 38.6 ± 10.4 years. Body mass index was 46.7 ± 7.2 kg/m(2). Follow-up was 12.7 ± 1.5 years. Weight loss was 17.6% ± 15.7% of baseline weight at 12-18 months and 17.1% ± 14.8% at 12.7 years. A significant reduction in blood glucose, total cholesterol, triglycerides, and systolic and diastolic blood pressure was observed at the short-term evaluation and confirmed in the long term. HDL-C was unchanged at 12-18 months and significantly increased at 12.7 years. Five coronary events (1.6%) were recorded during long-term follow-up. The rate of observed events was compared with the rate of events expected according to baseline 10-year probability of myocardial infarction calculated with the Prospective Cardiovascular Munster study (PROCAM) score. Observed rate (1.6%) was slightly lower than the expected rate (2.0%± 4.9%).
  
  
  CONCLUSIONS
  Stable weight loss and significant improvement of cardiovascular risk profile were observed in morbidly obese patients 10 years after laparoscopic adjustable gastric banding.
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy. Electronic address: luca.busetto@unipd.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Busetto
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: De Stefano
authors.affiliation: Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pigozzo
authors.affiliation: Department of Surgery, Regional Hospital of Vicenza, Vicenza, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Segato
authors.affiliation: Department of Surgery, Regional Hospital of Vicenza, Vicenza, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Luca
authors.affiliation: Department of Surgery, Regional Hospital of Vicenza, Vicenza, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Favretti
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000378:metabolism; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Cardiovascular risk; Gastric banding; Obesity; Obesity surgery