Coronary Calcium Scores 6 Years After Bariatric Surgery

Tiffany Priester, Travis G. Ault, Lance Davidson, Richard Gress, Ted D. Adams, Steven Hunt, Sheldon E. Litwin

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Obesity is associated with elevated coronary artery calcium (CAC), a marker of coronary atherosclerosis that is strongly predictive of cardiovascular events. We evaluated the effects of marked weight loss achieved through Roux-en-Y gastric bypass surgery (GBS) on CAC scores. Methods: We performed echocardiography and computed tomography of the heart in 149 subjects 6 years after enrollment in a prospective registry evaluating the cardiovascular effects of GBS. Coronary calcium scores, left ventricular ejection fraction, and left ventricular mass were measured. Results: At baseline, most coronary risk factors were similar between the GBS and nonsurgical groups including current smoking, systolic blood pressure, LDL-C, HDL-C, and TG. However, GBS patients were younger (4.7 years), less likely to be diabetic, and less likely to be postmenopausal. At 6 years after enrollment, CAC score was significantly lower in patients who underwent GBS than those without surgery (p < 0.01). GBS subjects had a lower likelihood of having measureable coronary calcium (odds ratio of CAC > 0 = 0.39; 95 % CI of (0.17, 0.90)). Significant predictors of 0 CAC were GBS, female gender, younger age, baseline BMI, and baseline LDL-C. Substituting change in BMI for group status as a predictor variable showed that BMI change also predicted CAC (p = 0.045). Changes in LDL-C did not predict the CAC differences between groups (p = 0.67). Conclusions: Sustained weight loss achieved through bariatric surgery is associated with less coronary calcification. This effect, which appears to be independent of changes in LDL-C, may contribute to lower cardiac mortality in patients with successful GBS.

Original languageEnglish
Pages (from-to)90-96
Number of pages7
JournalObesity Surgery
Volume25
Issue number1
DOIs
Publication statusPublished - 1 Jan 2015
Externally publishedYes

Fingerprint

Bariatric Surgery
Gastric Bypass
Calcium
Coronary Vessels
Weight Loss
Blood Pressure
Stroke Volume
Registries
Echocardiography
Coronary Artery Disease
Obesity
Smoking
Tomography
Mortality

Keywords

  • Atherosclerosis
  • Bariatric surgery
  • Coronary calcium
  • Obesity
  • Weight loss

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Priester, T., Ault, T. G., Davidson, L., Gress, R., Adams, T. D., Hunt, S., & Litwin, S. E. (2015). Coronary Calcium Scores 6 Years After Bariatric Surgery. Obesity Surgery, 25(1), 90-96. https://doi.org/10.1007/s11695-014-1327-6

Coronary Calcium Scores 6 Years After Bariatric Surgery. / Priester, Tiffany; Ault, Travis G.; Davidson, Lance; Gress, Richard; Adams, Ted D.; Hunt, Steven; Litwin, Sheldon E.

In: Obesity Surgery, Vol. 25, No. 1, 01.01.2015, p. 90-96.

Research output: Contribution to journalArticle

Priester, T, Ault, TG, Davidson, L, Gress, R, Adams, TD, Hunt, S & Litwin, SE 2015, 'Coronary Calcium Scores 6 Years After Bariatric Surgery', Obesity Surgery, vol. 25, no. 1, pp. 90-96. https://doi.org/10.1007/s11695-014-1327-6
Priester T, Ault TG, Davidson L, Gress R, Adams TD, Hunt S et al. Coronary Calcium Scores 6 Years After Bariatric Surgery. Obesity Surgery. 2015 Jan 1;25(1):90-96. https://doi.org/10.1007/s11695-014-1327-6
Priester, Tiffany ; Ault, Travis G. ; Davidson, Lance ; Gress, Richard ; Adams, Ted D. ; Hunt, Steven ; Litwin, Sheldon E. / Coronary Calcium Scores 6 Years After Bariatric Surgery. In: Obesity Surgery. 2015 ; Vol. 25, No. 1. pp. 90-96.
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abstract = "Background: Obesity is associated with elevated coronary artery calcium (CAC), a marker of coronary atherosclerosis that is strongly predictive of cardiovascular events. We evaluated the effects of marked weight loss achieved through Roux-en-Y gastric bypass surgery (GBS) on CAC scores. Methods: We performed echocardiography and computed tomography of the heart in 149 subjects 6 years after enrollment in a prospective registry evaluating the cardiovascular effects of GBS. Coronary calcium scores, left ventricular ejection fraction, and left ventricular mass were measured. Results: At baseline, most coronary risk factors were similar between the GBS and nonsurgical groups including current smoking, systolic blood pressure, LDL-C, HDL-C, and TG. However, GBS patients were younger (4.7 years), less likely to be diabetic, and less likely to be postmenopausal. At 6 years after enrollment, CAC score was significantly lower in patients who underwent GBS than those without surgery (p < 0.01). GBS subjects had a lower likelihood of having measureable coronary calcium (odds ratio of CAC > 0 = 0.39; 95 {\%} CI of (0.17, 0.90)). Significant predictors of 0 CAC were GBS, female gender, younger age, baseline BMI, and baseline LDL-C. Substituting change in BMI for group status as a predictor variable showed that BMI change also predicted CAC (p = 0.045). Changes in LDL-C did not predict the CAC differences between groups (p = 0.67). Conclusions: Sustained weight loss achieved through bariatric surgery is associated with less coronary calcification. This effect, which appears to be independent of changes in LDL-C, may contribute to lower cardiac mortality in patients with successful GBS.",
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N2 - Background: Obesity is associated with elevated coronary artery calcium (CAC), a marker of coronary atherosclerosis that is strongly predictive of cardiovascular events. We evaluated the effects of marked weight loss achieved through Roux-en-Y gastric bypass surgery (GBS) on CAC scores. Methods: We performed echocardiography and computed tomography of the heart in 149 subjects 6 years after enrollment in a prospective registry evaluating the cardiovascular effects of GBS. Coronary calcium scores, left ventricular ejection fraction, and left ventricular mass were measured. Results: At baseline, most coronary risk factors were similar between the GBS and nonsurgical groups including current smoking, systolic blood pressure, LDL-C, HDL-C, and TG. However, GBS patients were younger (4.7 years), less likely to be diabetic, and less likely to be postmenopausal. At 6 years after enrollment, CAC score was significantly lower in patients who underwent GBS than those without surgery (p < 0.01). GBS subjects had a lower likelihood of having measureable coronary calcium (odds ratio of CAC > 0 = 0.39; 95 % CI of (0.17, 0.90)). Significant predictors of 0 CAC were GBS, female gender, younger age, baseline BMI, and baseline LDL-C. Substituting change in BMI for group status as a predictor variable showed that BMI change also predicted CAC (p = 0.045). Changes in LDL-C did not predict the CAC differences between groups (p = 0.67). Conclusions: Sustained weight loss achieved through bariatric surgery is associated with less coronary calcification. This effect, which appears to be independent of changes in LDL-C, may contribute to lower cardiac mortality in patients with successful GBS.

AB - Background: Obesity is associated with elevated coronary artery calcium (CAC), a marker of coronary atherosclerosis that is strongly predictive of cardiovascular events. We evaluated the effects of marked weight loss achieved through Roux-en-Y gastric bypass surgery (GBS) on CAC scores. Methods: We performed echocardiography and computed tomography of the heart in 149 subjects 6 years after enrollment in a prospective registry evaluating the cardiovascular effects of GBS. Coronary calcium scores, left ventricular ejection fraction, and left ventricular mass were measured. Results: At baseline, most coronary risk factors were similar between the GBS and nonsurgical groups including current smoking, systolic blood pressure, LDL-C, HDL-C, and TG. However, GBS patients were younger (4.7 years), less likely to be diabetic, and less likely to be postmenopausal. At 6 years after enrollment, CAC score was significantly lower in patients who underwent GBS than those without surgery (p < 0.01). GBS subjects had a lower likelihood of having measureable coronary calcium (odds ratio of CAC > 0 = 0.39; 95 % CI of (0.17, 0.90)). Significant predictors of 0 CAC were GBS, female gender, younger age, baseline BMI, and baseline LDL-C. Substituting change in BMI for group status as a predictor variable showed that BMI change also predicted CAC (p = 0.045). Changes in LDL-C did not predict the CAC differences between groups (p = 0.67). Conclusions: Sustained weight loss achieved through bariatric surgery is associated with less coronary calcification. This effect, which appears to be independent of changes in LDL-C, may contribute to lower cardiac mortality in patients with successful GBS.

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