Cleveland Clinic study shows weight loss surgery cuts risk of heart complications and death in patients with obstructive sleep apnea and obesity
A Cleveland Clinic study shows that bariatric surgery performed in patients with obesity and moderate to severe obstructive sleep apnea is associated with a significantly lower risk of death and major adverse cardiovascular events, compared with patients who did not have the surgery.
This study was published in the Journal of the American College of Cardiology.
The Cleveland Clinic-led MOSAIC (Metabolic surgery for OSA and Incident Cardiovascular disease) research reported data on the long-term cardiovascular outcomes of bariatric surgery in patients with obstructive sleep apnea and obesity.
The observational study included 13,657 adult patients with a body mass index between 35-70 and the presence of moderate to severe obstructive sleep apnea (diagnosed by a sleep study test) between 2004 and 2018. Baseline clinical characteristics of 970 patients who underwent bariatric surgery were balanced with 12,687 patients in the nonsurgical control group using overlap weighting methods. Follow-up ended in September 2022.
At the end of the study period, results show that the cumulative incidence of major adverse cardiovascular events at 10 years was 27% in the bariatric surgery group and 35.6% in the nonsurgical group. A major adverse cardiovascular event is defined as the first occurrence of coronary artery events, cerebrovascular events, heart failure, atrial fibrillation, and all-cause mortality. Additional analysis shows that the cumulative incidence of all-cause mortality at 10 years was 9.1% in the bariatric surgery group and 12.5% in the nonsurgical group.
At 10 years, patients in the bariatric surgery group lost 33.2 kg and patients in the nonsurgical control group lost 6.64 kg. Patients in the bariatric surgery group maintained 25% weight loss at least up to 10 years following the procedure.