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Laparoscopic Sleeve Gastrectomy Reduces the Predicted Coronary Heart Disease Risk and the Vascular Age in Obese Subjects

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Laparoscopic Sleeve Gastrectomy Reduces the Predicted Coronary Heart Disease Risk and the Vascular Age in Obese Subjects

M. Iancu, C. Copăescu, M. Șerban, C. Ginghină
Original article, no. 5, 2013
Background: Obesity is associated with high prevalence ofcoronary heart disease (CHD) and long term increasedcardiovascular morbi-mortality. There are no data regarding theeffect of laparoscopic sleeve gastrectomy (LSG) on long-termCHD - risk. It is known that “a man is as old as hisarteries” and this concept is illustrated by Framinghamcoronary risk score, which can predict vascular age.Purpose: To assess the 10-year CHD risk in patients withobesity, preoperatively, and 6 and 12 months after LSG.Methods: 47 consecutive obese subjects (44.7% males, mean age 39.8 years) scheduled for LSG were prospectively studiedbefore and 6 and 12 months after surgery. The 10 years CHDrisk and corresponding vascular age were calculated usingFramingham risk score.Results: The body mass index (BMI) decreased from 44.6 Â+-10.6 kg m2 preoperatively to 32.2Â+-6.9 kg m2 and to 29.4 Â+- 5.4kg m2 at 6 and 12 months follow-up (both p 0.05). Meanexcessive weight loss (EWL) was 67.3Â+-23.7% and 78.3 Â+-23.4% at 6 and 12 months postoperatively. At 6 and 12 monthsafter LSG, there was a marked improvment of lipid profile(decrease of total cholesterol, LDL-cholesterol, triglycerides andincrease of HDL-cholesterol) and a significant decrease inprevalence of diabetes mellitus, systemic hypertension andsmoking. The 10-year CHD risk reduced from 10.1% preoperativelyto 3.5% and to 2.2% at 6 and 12 months aftersurgery (both p 0.05). Patients' mean vascular age was 65.6years preoperatively and decreased to 45.8 years 6 monthspostoperatively (p 0.05) and to 40.7 years one year afterLSG (p 0.05 vs. 6 months postoperatively, p=NS vs.chronological age).Conclusions: In obese subjects, CHD risk is significantlyreduced early, beginning with 6 months after LSG and isdiminished with 80% one year postoperatively. Despite thefact that not all patients had achieved the ideal weight yet,mean vascular age is similar to their chronological age one yearafter surgery.