Bariatric surgery may provide better protection than uvulopalatopharyngoplasty against major adverse cardiovascular events in obese patients with obstructive sleep apnea

被引：6

作者：

Chen, Tien-Yu ^{[1
,2
,3
]}

Liu, Chien-Ting ^{[4
]}

Chung, Chi-Hsiang ^{[5
,6
,7
]}

Hung, Shao-Lun ^{[8
]}

Chien, Wu-Chien ^{[5
,6
,9
]}

Chen, Jian-Han ^{[8
,10
,11
]}

机构：

[1] Natl Def Med Ctr, Triserv Gen Hosp, Sch Med, Dept Psychiat, Taipei, Taiwan

[2] Natl Yang Ming Univ, Inst Brain Sci, Taipei, Taiwan

[3] Natl Yang Ming Univ, Sleep Res Ctr, Taipei, Taiwan

[4] Natl Def Med Ctr, Triserv Gen Hosp, Sch Med, Dept Surg,Div Cardiovasc Surg, Taipei, Taiwan

[5] Natl Def Med Ctr, Triserv Gen Hosp, Dept Med Res, 7115R,325,Sect 2,Cheng Kung Rd, Taipei 11490, Taiwan

[6] Natl Def Med Ctr, Sch Publ Hlth, Taipei, Taiwan

[7] Taiwanese Injury Prevent & Safety Promot Assoc, Taipei, Taiwan

[8] E Da Hosp, Div Gen Surg, Kaohsiung, Taiwan

[9] Natl Def Med Ctr, Grad Inst Life Sci, Taipei, Taiwan

[10] E Da Hosp, Bariatr & Metab Int Surg Ctr, Kaohsiung, Taiwan

[11] I Shou Univ, Coll Med, Sch Med, Kaohsiung, Taiwan

来源：

SURGERY FOR OBESITY AND RELATED DISEASES | 2021年 / 17卷 / 04期

关键词：

Obstructive sleep apnea; Bariatric surgery; Uvulopalatopharyngoplasty; Obesity; Cardiovascular events; POSITIVE AIRWAY PRESSURE; METABOLIC SYNDROME; ISCHEMIC-STROKE; RISK; DISEASE; POPULATION; ASSOCIATION; CPAP; MEN; PATHOPHYSIOLOGY;

D O I：

10.1016/j.soard.2020.11.018

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: The major adverse cardiovascular events (MACE) risk is unclear among Asian obese patients with obstructive sleep apnea (OSA) who undergo bariatric surgery (BS) or uvulopalatopharyngoplasty (UPPP). Objectives: We aimed to evaluate differences between Asian obese patients with OSA who underwent BS or UPPP regarding MACE. Setting: The Longitudinal Health Insurance Database, a subset of the NHI Research Database (NHIRD) originated from the National Health Insurance (NHI) program in Taiwan, which comprises information from 2 million randomly sampled individuals between 2000 and 2015. Methods: Participants aged 18-55 years whose diagnoses corresponded with codes in the International Classification of Diseases, Ninth Revision, Clinical Modification for BS, UPPP, obesity, and OSA were included in this population-based, matched cohort study of Taiwan's insurance claims data gathered between 2000 and 2015. Obese patients with OSA who underwent BS or UPPP were propensity score matched; the study's outcome was MACE. Results: A total of 1336 patients, comprising 668 in each of the BS and UPPP cohorts, were enrolled. After a mean follow-up period of 8.51 years, 166 patients, comprising 52 in the BS cohort and 114 in the UPPP cohort, experienced MACE. The adjusted hazard ratio (aHR) for MACE was .592 (95% confidence interval CI = .324-.789; P < .001). The BS cohort had lower risks of stroke (aHR = .663; 95% CI = .312-.890; P < .001), myocardial infarction (aHR = .116; 95% CI = .052-.135; P < .001), and mortality (aHR = .779; 95% CI = .423-.948; P = .001) than the UPPP cohort. Conclusion: BS may provide greater protection against MACE than UPPP in Asian obese patients with OSA. Additional mechanistic research is needed to clarify differences between BS and UPPP in these patients. (C) 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

引用

页码：780 / 791

页数：12

共 51 条

[41] MAXILLOFACIAL SURGERY AND NASAL CPAP - A COMPARISON OF TREATMENT FOR OBSTRUCTIVE SLEEP-APNEA SYNDROME [J].