Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients With Heart Failure
•Significant reductions in oral diuretic use were observed, with an average reduction of 65% at 24 months after metabolic surgery.•Decrease in body mass index and total body weight loss observed at 24 months are greater than reported in the general population.•Improvements in hemoglobin A1c levels w...
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| Veröffentlicht in: | The American journal of cardiology 2024-09, Vol.226, p.128-133 |
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| creator | Kachmar, Michael Corpodean, Florina LaChute, Courtney Popiv, Iryna Cook, Michael W. Danos, Denise M. Albaugh, Vance L. Moraes, Denzil L. Tang, W.H. Wilson Schauer, Philip R. |
| description | •Significant reductions in oral diuretic use were observed, with an average reduction of 65% at 24 months after metabolic surgery.•Decrease in body mass index and total body weight loss observed at 24 months are greater than reported in the general population.•Improvements in hemoglobin A1c levels were sustained ≥24 months postoperatively.•Trends toward less emergency department utilization for cardiac conditions and intravenous diuresis were observed.•Metabolic surgery indicates promising metabolic and cardiac benefits in patients with heart failure.
The beneficial impacts of metabolic surgery (MS) on patients with heart failure (HF) are incompletely characterized. We aimed to describe the cardiac and metabolic effects of MS in patients with HF and hypothesized that patients with HF would experience both improved metabolic and HF profiles using glycemic control and diuretic dependency as surrogate markers. In this single-center, university-affiliated academic study in the United States, a review of 2,342 hospital records of patients who underwent MS (2017 to 2023) identified 63 patients with a medical history of HF. Preoperative characteristics, 30-day outcomes, and up to 2-year biometric and metabolic outcomes, medication usage, and emergency department utilization were collected. At 24 months, mean body mass index change was −16 kg/m2 (p |
| doi_str_mv | 10.1016/j.amjcard.2024.07.012 |
| format | Article |
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The beneficial impacts of metabolic surgery (MS) on patients with heart failure (HF) are incompletely characterized. We aimed to describe the cardiac and metabolic effects of MS in patients with HF and hypothesized that patients with HF would experience both improved metabolic and HF profiles using glycemic control and diuretic dependency as surrogate markers. In this single-center, university-affiliated academic study in the United States, a review of 2,342 hospital records of patients who underwent MS (2017 to 2023) identified 63 patients with a medical history of HF. Preoperative characteristics, 30-day outcomes, and up to 2-year biometric and metabolic outcomes, medication usage, and emergency department utilization were collected. At 24 months, mean body mass index change was −16 kg/m2 (p <0.001) that corresponded to a mean percentage total body weight loss of 29% (p <0.001). Weight loss was accompanied by significant reductions in hemoglobin A1c (p <0.001) and a 65% decrease in diuretic use at 24 months after surgery (p <0.001). Similarly, emergency visits for cardiac conditions (p = 0.06) and intravenous diuresis (p = 0.07) trended favorably at 1 year after surgery compared with 1 year before surgery but were not statistically significant. In conclusion, in patients with HF who were carefully selected, MS appears to provide significant reduction in oral diuretic dependency, and metabolic improvements with trends toward lower rates of emergency department utilization.</description><identifier>ISSN: 0002-9149</identifier><identifier>ISSN: 1879-1913</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2024.07.012</identifier><identifier>PMID: 39029720</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Accreditation ; Body mass index ; Body size ; Body weight ; Body weight loss ; Cardiac arrest ; Cardiac catheterization ; Cardiopulmonary resuscitation ; Chronic obstructive pulmonary disease ; Clinical outcomes ; Congestive heart failure ; CPR ; Diabetes ; Diuresis ; diuretic resistance ; Diuretics ; Ejection fraction ; Emergency medical care ; Emergency medical services ; Gastroesophageal reflux ; Gastrointestinal surgery ; Heart failure ; Hemoglobin ; Hyperlipidemia ; Hypertension ; Intubation ; Kidney diseases ; metabolic surgery ; Metabolism ; Obesity ; Patients ; Pneumonia ; Sepsis ; Sleep apnea ; Statistical analysis ; Surgery ; Thromboembolism ; Thrombosis ; Weight control ; Weight loss</subject><ispartof>The American journal of cardiology, 2024-09, Vol.226, p.128-133</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c271t-9f912beae62b5e04642d49730a00ea74c3c256a6167d516ccb5498c1d08df72f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914924005393$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39029720$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kachmar, Michael</creatorcontrib><creatorcontrib>Corpodean, Florina</creatorcontrib><creatorcontrib>LaChute, Courtney</creatorcontrib><creatorcontrib>Popiv, Iryna</creatorcontrib><creatorcontrib>Cook, Michael W.</creatorcontrib><creatorcontrib>Danos, Denise M.</creatorcontrib><creatorcontrib>Albaugh, Vance L.</creatorcontrib><creatorcontrib>Moraes, Denzil L.</creatorcontrib><creatorcontrib>Tang, W.H. Wilson</creatorcontrib><creatorcontrib>Schauer, Philip R.</creatorcontrib><title>Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients With Heart Failure</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>•Significant reductions in oral diuretic use were observed, with an average reduction of 65% at 24 months after metabolic surgery.•Decrease in body mass index and total body weight loss observed at 24 months are greater than reported in the general population.•Improvements in hemoglobin A1c levels were sustained ≥24 months postoperatively.•Trends toward less emergency department utilization for cardiac conditions and intravenous diuresis were observed.•Metabolic surgery indicates promising metabolic and cardiac benefits in patients with heart failure.
The beneficial impacts of metabolic surgery (MS) on patients with heart failure (HF) are incompletely characterized. We aimed to describe the cardiac and metabolic effects of MS in patients with HF and hypothesized that patients with HF would experience both improved metabolic and HF profiles using glycemic control and diuretic dependency as surrogate markers. In this single-center, university-affiliated academic study in the United States, a review of 2,342 hospital records of patients who underwent MS (2017 to 2023) identified 63 patients with a medical history of HF. Preoperative characteristics, 30-day outcomes, and up to 2-year biometric and metabolic outcomes, medication usage, and emergency department utilization were collected. At 24 months, mean body mass index change was −16 kg/m2 (p <0.001) that corresponded to a mean percentage total body weight loss of 29% (p <0.001). Weight loss was accompanied by significant reductions in hemoglobin A1c (p <0.001) and a 65% decrease in diuretic use at 24 months after surgery (p <0.001). Similarly, emergency visits for cardiac conditions (p = 0.06) and intravenous diuresis (p = 0.07) trended favorably at 1 year after surgery compared with 1 year before surgery but were not statistically significant. In conclusion, in patients with HF who were carefully selected, MS appears to provide significant reduction in oral diuretic dependency, and metabolic improvements with trends toward lower rates of emergency department utilization.</description><subject>Accreditation</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Body weight</subject><subject>Body weight loss</subject><subject>Cardiac arrest</subject><subject>Cardiac catheterization</subject><subject>Cardiopulmonary resuscitation</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clinical outcomes</subject><subject>Congestive heart failure</subject><subject>CPR</subject><subject>Diabetes</subject><subject>Diuresis</subject><subject>diuretic resistance</subject><subject>Diuretics</subject><subject>Ejection fraction</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Gastroesophageal reflux</subject><subject>Gastrointestinal surgery</subject><subject>Heart failure</subject><subject>Hemoglobin</subject><subject>Hyperlipidemia</subject><subject>Hypertension</subject><subject>Intubation</subject><subject>Kidney diseases</subject><subject>metabolic surgery</subject><subject>Metabolism</subject><subject>Obesity</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Sepsis</subject><subject>Sleep apnea</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><subject>Weight control</subject><subject>Weight loss</subject><issn>0002-9149</issn><issn>1879-1913</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1v1DAQhi0EotvCTwBZ4sIlYfwRJz4htNAWqahIsOJoOc4EHCVxsR2k_ntc7cKBC6fRjJ53ZvQQ8oJBzYCpN1Ntl8nZONQcuKyhrYHxR2THulZXTDPxmOwAgFeaSX1GzlOaSstYo56SM6GB65bDjhz2s1-9szO93bILCyYaRvoJs-3D7B39ssXvGO9pWOl7v0XMZXZISP1KP9vscc2JfvP5B71GGzO9tH4u1DPyZLRzwuenekEOlx--7q-rm9urj_t3N5XjLcuVHjXjPVpUvG8QpJJ8kLoVYAHQttIJxxtlFVPt0DDlXN9I3Tk2QDeMLR_FBXl93HsXw88NUzaLTw7n2a4YtmQEdLwTshFdQV_9g05hi2v5rlBadKqRXBSqOVIuhpQijuYu-sXGe8PAPHg3kzl5Nw_eDbSmeC-5l6ftW7_g8Df1R3QB3h4BLDp-eYwmuWLP4eAjumyG4P9z4je1iJSm</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Kachmar, Michael</creator><creator>Corpodean, Florina</creator><creator>LaChute, Courtney</creator><creator>Popiv, Iryna</creator><creator>Cook, Michael W.</creator><creator>Danos, Denise M.</creator><creator>Albaugh, Vance L.</creator><creator>Moraes, Denzil L.</creator><creator>Tang, W.H. 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Wilson</au><au>Schauer, Philip R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients With Heart Failure</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>226</volume><spage>128</spage><epage>133</epage><pages>128-133</pages><issn>0002-9149</issn><issn>1879-1913</issn><eissn>1879-1913</eissn><abstract>•Significant reductions in oral diuretic use were observed, with an average reduction of 65% at 24 months after metabolic surgery.•Decrease in body mass index and total body weight loss observed at 24 months are greater than reported in the general population.•Improvements in hemoglobin A1c levels were sustained ≥24 months postoperatively.•Trends toward less emergency department utilization for cardiac conditions and intravenous diuresis were observed.•Metabolic surgery indicates promising metabolic and cardiac benefits in patients with heart failure.
The beneficial impacts of metabolic surgery (MS) on patients with heart failure (HF) are incompletely characterized. We aimed to describe the cardiac and metabolic effects of MS in patients with HF and hypothesized that patients with HF would experience both improved metabolic and HF profiles using glycemic control and diuretic dependency as surrogate markers. In this single-center, university-affiliated academic study in the United States, a review of 2,342 hospital records of patients who underwent MS (2017 to 2023) identified 63 patients with a medical history of HF. Preoperative characteristics, 30-day outcomes, and up to 2-year biometric and metabolic outcomes, medication usage, and emergency department utilization were collected. At 24 months, mean body mass index change was −16 kg/m2 (p <0.001) that corresponded to a mean percentage total body weight loss of 29% (p <0.001). Weight loss was accompanied by significant reductions in hemoglobin A1c (p <0.001) and a 65% decrease in diuretic use at 24 months after surgery (p <0.001). Similarly, emergency visits for cardiac conditions (p = 0.06) and intravenous diuresis (p = 0.07) trended favorably at 1 year after surgery compared with 1 year before surgery but were not statistically significant. In conclusion, in patients with HF who were carefully selected, MS appears to provide significant reduction in oral diuretic dependency, and metabolic improvements with trends toward lower rates of emergency department utilization.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39029720</pmid><doi>10.1016/j.amjcard.2024.07.012</doi><tpages>6</tpages></addata></record> |
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| subjects | Accreditation Body mass index Body size Body weight Body weight loss Cardiac arrest Cardiac catheterization Cardiopulmonary resuscitation Chronic obstructive pulmonary disease Clinical outcomes Congestive heart failure CPR Diabetes Diuresis diuretic resistance Diuretics Ejection fraction Emergency medical care Emergency medical services Gastroesophageal reflux Gastrointestinal surgery Heart failure Hemoglobin Hyperlipidemia Hypertension Intubation Kidney diseases metabolic surgery Metabolism Obesity Patients Pneumonia Sepsis Sleep apnea Statistical analysis Surgery Thromboembolism Thrombosis Weight control Weight loss |
| title | Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients With Heart Failure |
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