[Effects of gastric bypass on estimated cardiovascular risk in morbidly obese patients with metabolic syndrome]. / Efectos del bypass gástrico sobre el riesgo cardiovascular estimado.

INTRODUCTION: The major goal of surgical treatment in morbid obesity is to decrease morbidity and mortality associated with excess weight. In this sense, the main factors of death are cardiovascular disease and metabolic syndrome. The objective of this study is to evaluate the effects of gastric bypass on cardiovascular risk estimation in patients after bariatric surgery. MATERIAL AND METHODS: We retrospectively evaluated pre and postoperative cardiovascular risk estimation of 402 morbidly obese patients who underwent laparoscopic gastric bypass. The major variable studied is the cardiovascular risk estimation that is calculated preoperatively and after 12 months. Cardiovascular risk estimation analysis has been performed with the REGICOR Equation. REGICOR formulation allows calculating a 10 year risk of cardiovascular events adapted to the Spanish population and is expressed in percentages. RESULTS: We reported an overall 4.1±3.0 mean basal REGICOR score. One year after the operation, cardiovascular risk estimation significantly decreased to 2,2±1,6 (P<.001). In patients with metabolic syndrome according to ATP-III criteria, basal REGICOR score was 4.8±3.1 whereas in no metabolic syndrome patients 2.2±1.8. Evaluation 12 months after surgery, determined a significant reduction in both groups (metabolic syndrome and non metabolic syndrome) with a mean REGICOR score of 2.3±1.6 and 1.6±1.0 respectively. CONCLUSION: The results of our study demonstrate favorable effects of gastric bypass on the cardiovascular risk factors included in the REGICOR equation.

Efectos del bypass gástrico sobre el riesgo cardiovascular estimado / Effects of gastric bypass on estimated cardiovascular risk in morbidly obese patients with metabolic syndrome

INTRODUCCIÓN: El objetivo final del tratamiento quirúrgico en la obesidad mórbida es el descenso de la morbimortalidad asociada al exceso de peso. En este sentido debemos centrarnos en la enfermedad cardiovascular y el síndrome metabólico, que son las causas principales de mortalidad. El objetivo del estudio es valorar el efecto del bypass gástrico sobre el riesgo cardiovascular estimado en los pacientes sometidos a cirugía bariátrica. MATERIAL Y MÉTODOS: Estudio clínico retrospectivo y observacional desarrollado en 402 pacientes sometidos a bypass gástrico por laparoscopia. La variable principal a estudio es el riesgo cardiovascular estimado, que se mide en el preoperatorio y a los 12 meses. Para el cálculo del riesgo estimado se utiliza la ecuación REGICOR, que se expresa en forma de porcentaje y calcula el riesgo a 10 años de presentar enfermedad cardiovascular. RESULTADOS: En situación basal observamos como media un índice REGICOR de 4,1 ± 3,0. A los 12 meses de la intervención la estimación del riesgo cardiovascular disminuyó significativamente a 2,2 ± 1,6 (p < 0,001). En los sujetos con el diagnóstico de síndrome metabólico según definición del ATP-III, el REGICOR basal fue de 4,8 ± 3,1, mientras que en aquellos sin síndrome fue de 2,2 ± 1,8. A los 12 meses observamos una reducción significativa en ambos grupos (síndrome metabólico y no síndrome) con un REGICOR medio de 2,3 ± 1,6 y 1,6 ± 1,0 respectivamente. CONCLUSIÓN: Los resultados observados en nuestro estudio demuestran los efectos favorables del bypass gástrico sobre los factores de riesgo cardiovascular incluidos en la ecuación REGICOR

INTRODUCTION: The major goal of surgical treatment in morbid obesity is to decrease morbidity and mortality associated with excess weight. In this sense, the main factors of death are cardiovascular disease and metabolic syndrome. The objective of this study is to evaluate the effects of gastric bypass on cardiovascular risk estimation in patients after bariatric surgery. MATERIAL AND METHODS: We retrospectively evaluated pre and postoperative cardiovascular risk estimation of 402 morbidly obese patients who underwent laparoscopic gastric bypass. The major variable studied is the cardiovascular risk estimation that is calculated preoperatively and after 12 months. Cardiovascular risk estimation analysis has been performed with the REGICOR Equation. REGICOR formulation allows calculating a 10-year risk of cardiovascular events adapted to the Spanish population and is expressed in percentages. RESULTS: We reported an overall 4.1 ± 3.0 mean basal REGICOR score. One year after the operation, cardiovascular risk estimation significantly decreased to 2,2 ± 1,6 (P < .001). In patients with metabolic syndrome according to ATP-III criteria, basal REGICOR score was 4.8 ± 3.1 whereas in no metabolic syndrome patients 2.2 ± 1.8. Evaluation 12 months after surgery, determined a significant reduction in both groups (metabolic syndrome and non-metabolic syndrome) with a mean REGICOR score of 2.3 ± 1.6 and 1.6 ± 1.0 respectively. CONCLUSION: The results of our study demonstrate favorable effects of gastric bypass on the cardiovascular risk factors included in the REGICOR equation