Does bariatric surgery change the risk of acute ischemic stroke in patients with a history of transient ischemic attack? A nationwide analysis.

Autor:	Valera RJ; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Botero-Fonnegra C; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Cogollo VJ; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Sarmiento-Cobos M; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Montorfano L; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Rivera C; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Hong L; Biostatistics Section, Department of Clinical Research, Cleveland Clinic Florida, Weston, Florida., Lo Menzo E; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Szomstein S; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida., Rosenthal RJ; Department of Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida. Electronic address: rosentr@ccf.org.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2023 Jun; Vol. 19 (6), pp. 548-554. Date of Electronic Publication: 2022 Nov 23.
DOI:	10.1016/j.soard.2022.11.013
Abstrakt:	Background: Stroke is the second leading cause of death worldwide and fifth in the United States, and it represents the major cause of disability in older adults. Objective: We aimed to determine the risk of acute ischemic stroke (AIS) in individuals with obesity with a history of transient ischemic attack (TIA) compared with patients with a history of bariatric surgery. Setting: Academic hospital, United States. Methods: Using the Nationwide Inpatient Sample (NIS) database from 2010 to 2015, we retrospectively identified patients with obesity and past medical history of TIA and divided them into 2 groups: a treatment group of patients who underwent bariatric surgery, and a control group of patients with obesity. We compared incidence of new AIS in both groups using a univariate analysis and multivariate regression model. Covariates included were lifestyle (smoking status, alcohol habits, cocaine use), family history of stroke, co-morbidities (diabetes, hypertension, hyperlipidemia, atrial fibrillation) and long-term medical treatment (antiplatelet/antithrombotic treatment). Results: A total of 91,640 patients met inclusion criteria, of which treatment patients were 12.3% (n = 11,284) and control patients 87.6% (n = 80,356). The average age of the treatment group was 62.9 ± 17.08 years, and the average of the control was 59.6 ± 12.74 years. The rate of AIS in the treatment group was significantly lower compared with the control group (2.8% versus 4.2%, P < .0001). After adjusting for covariables, the risk difference of AIS was still significant between groups (odds ratio = 1.33, P < .0001), showing that patients in the treatment group were less likely to have AIS compared with the control group. Conclusions: After analyzing nationwide information, we conclude bariatric surgery helps decrease risk of AIS in patients with a history of TIA. However, this comparison is limited by the nature of the database; further studies are needed to better understand these results. (Copyright © 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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