TY - JOUR
T1 - Distribution of 10-year and lifetime predicted risk for cardiovascular disease prior to surgery in the longitudinal assessment of bariatric surgery-2 study
AU - MacKey, Rachel H.
AU - Belle, Steven H.
AU - Courcoulas, Anita P.
AU - Dakin, Greg F.
AU - Deveney, Clifford W.
AU - Flum, David R.
AU - Garcia, Luis
AU - King, Wendy C.
AU - Kuller, Lewis H.
AU - Mitchell, James E.
AU - Pomp, Alfons
AU - Pories, Walter J.
AU - Wolfe, Bruce M.
N1 - Funding Information:
LABS-2 was funded by a cooperative agreement (Grant DCC-U01 DK066557 ) by the National Institute of Diabetes and Digestive and Kidney Diseases ; Grant U01-DK66667 from Columbia-Presbyterian Hospital , New York, New York in collaboration with Grant UL1-RR024996 from Cornell University Medical Center, Clinical and Translational Research Center (CTRC), Ithaca, New York; Grant U01-DK66568 from the University of Washington , Seattle, Washington in collaboration with Grant M01RR-00037 from CTRC ; Grant U01-DK66471 from the Neuropsychiatric Research Institute ; Grant U01-DK66526 from East Carolina University , Greenville, North Carolina; Grant U01-DK66585 from the University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania in collaboration with Grant UL1-RR024153 from CTRC ; and Grant U01-DK66555 from Oregon Health and Science University , Portland, Oregon.
PY - 2012/10/15
Y1 - 2012/10/15
N2 - Primary prevention guidelines recommend calculation of lifetime cardiovascular disease (CVD) predicted risk in patients who may not meet criteria for high short-term (10-year) Adult Treatment Panel III risk for coronary heart disease (CHD). Extreme obesity and bariatric surgery are more common in women who often have low short-term predicted CHD risk. The distribution and correlates of lifetime CVD predicted risk, however, have not yet been evaluated in bariatric surgical candidates. Using established 10-year (Adult Treatment Panel III) CHD and lifetime CVD risk prediction algorithms and presurgery risk factors, participants from the Longitudinal Assessment of Bariatric Surgery-2 study without prevalent CVD (n = 2,070) were stratified into 3 groups: low 10-year (<10%)/low lifetime (<39%) predicted risk, low 10-year (<10%)/high lifetime (<39%) predicted risk, and high 10-year (<10%) predicted risk or diagnosed diabetes. Participants were predominantly white (86%) and women (80%) with a median age of 45 years and median body mass index of 45.6 kg/m2. High 10-year CHD predicted risk was common (36.5%) and associated with diabetes, male gender, and older age, but not with higher body mass index or high-sensitivity C-reactive protein. Most participants (76%) with low 10-year predicted risk had high lifetime CVD predicted risk, which was associated with dyslipidemia and hypertension but not with body mass index, waist circumference, high-density lipoprotein cholesterol, or high-sensitivity C-reactive protein. In conclusion, bariatric surgical candidates without diabetes or existing CVD are likely to have low short-term, but high lifetime CVD predicted risk. Current data support the need for long-term monitoring and treatment of increased CVD risk factors in bariatric surgical patients to maximize lifetime CVD risk decrease.
AB - Primary prevention guidelines recommend calculation of lifetime cardiovascular disease (CVD) predicted risk in patients who may not meet criteria for high short-term (10-year) Adult Treatment Panel III risk for coronary heart disease (CHD). Extreme obesity and bariatric surgery are more common in women who often have low short-term predicted CHD risk. The distribution and correlates of lifetime CVD predicted risk, however, have not yet been evaluated in bariatric surgical candidates. Using established 10-year (Adult Treatment Panel III) CHD and lifetime CVD risk prediction algorithms and presurgery risk factors, participants from the Longitudinal Assessment of Bariatric Surgery-2 study without prevalent CVD (n = 2,070) were stratified into 3 groups: low 10-year (<10%)/low lifetime (<39%) predicted risk, low 10-year (<10%)/high lifetime (<39%) predicted risk, and high 10-year (<10%) predicted risk or diagnosed diabetes. Participants were predominantly white (86%) and women (80%) with a median age of 45 years and median body mass index of 45.6 kg/m2. High 10-year CHD predicted risk was common (36.5%) and associated with diabetes, male gender, and older age, but not with higher body mass index or high-sensitivity C-reactive protein. Most participants (76%) with low 10-year predicted risk had high lifetime CVD predicted risk, which was associated with dyslipidemia and hypertension but not with body mass index, waist circumference, high-density lipoprotein cholesterol, or high-sensitivity C-reactive protein. In conclusion, bariatric surgical candidates without diabetes or existing CVD are likely to have low short-term, but high lifetime CVD predicted risk. Current data support the need for long-term monitoring and treatment of increased CVD risk factors in bariatric surgical patients to maximize lifetime CVD risk decrease.
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U2 - 10.1016/j.amjcard.2012.05.054
DO - 10.1016/j.amjcard.2012.05.054
M3 - Article
C2 - 22742719
AN - SCOPUS:84866735198
SN - 0002-9149
VL - 110
SP - 1130
EP - 1137
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -