Remission of Obesity-Related Sleep Apnea and Its Effect on Mortality and Cardiovascular Events after Metabolic and Bariatric Surgery: A Propensity-Matched Cohort Study

Feb 19, 2024Journal of the American College of Surgeons

How Weight-Loss Surgery May Improve Obesity-Related Sleep Apnea and Lower Risks of Death and Heart Problems

AI simplified

Abstract

Remission of obstructive sleep apnea (OSA) was achieved in 74% of patients after metabolic and bariatric surgery.

Patients who achieved remission from OSA showed a lower risk of overall mortality at 10 years (6.0% vs 9.1%).
The incidence of major cardiovascular events (MACEs) was also lower in patients with OSA remission (3.4% vs 5.8%).
The long-term risk of mortality and MACEs for patients in remission was similar to that of patients without OSA at baseline.
A follow-up for patients who do not achieve remission from OSA is important.

AI simplified

BACKGROUND: Although obstructive sleep apnea (OSA) is common among patients with obesity and linked to cardiovascular disease, there is a lack of studies evaluating the effects of reaching remission from OSA after metabolic and bariatric surgery.

STUDY DESIGN: A registry-based nationwide study including patients operated with sleeve gastrectomy or Roux-en-Y gastric bypass from 2007 until 2019 in Sweden. Patients who reached remission of OSA were compared with those who did not reach remission and a propensity score-matched control group of patients without OSA at the time of operation. The main outcome was overall mortality, and secondary outcome was major cardiovascular events (MACEs).

RESULTS: In total, 5,892 patients with OSA and 11,552 matched patients without OSA completed a 1-year follow-up and were followed for a median of 6.8 years. Remission of OSA was seen for 4,334 patients (74%). Patients in remission had a lower risk for overall mortality (cumulative incidence 6.0% vs 9.1%; p < 0.001) and MACE (cumulative incidence 3.4% vs 5.8%; p < 0.001) at 10 years after operation compared with those who did not reach remission. The risk was similar to that of the control group without OSA at baseline (cumulative incidence for mortality 6%, p = 0.493, for MACE 3.7%, p = 0.251).

CONCLUSIONS: The remission rate of OSA was high after metabolic and bariatric surgery. This was in turn associated with reduced risk for death and MACE compared with patients who did not achieve remission reaching a similar risk seen among patients without OSA at baseline. A diligent follow-up of patients who do not reach remission remains important.

Full Text

Full text is available at the source.

View full text ↗

Abstract

Full Text

Related papers

what lands in your inbox each week: