Corresponding Author: Steven E. Nissen, MD, Cleveland Clinic JB-20, 9500 Euclid Ave, Cleveland, OH 44195 (nissens@ccf.org).
Accepted for Publication: August 19, 2019.
Published Online: September 2, 2019. doi:10.1001/jama.2019.14231
Author Contributions: Dr Aminian and Mr Zajichek had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Aminian, Zajichek, Arterburn, Brethauer, Schauer, Nissen.
Acquisition, analysis, or interpretation of data: Aminian, Zajichek, Wolski, Schauer, Kattan, Nissen.
Drafting of the manuscript: Aminian, Nissen.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Aminian, Zajichek, Wolski, Nissen.
Obtained funding: Aminian.
Administrative, technical, or material support: Aminian, Zajichek, Wolski, Schauer, Nissen.
Supervision: Aminian, Arterburn, Kattan, Nissen.
Conflict of Interest Disclosures: Dr Aminian reported receiving grants from Medtronic. Dr Arterburn reported receiving grants from the National Institutes of Health (NIH) and the Patient-Centered Outcomes Research Institute and receiving nonfinancial support from International Federation for the Surgery of Obesity and Metabolic Disorders Latin America Chapter. Dr Brethauer reported receiving grants from Medtronic and GI Windows. Dr Schauer reported receiving grants from Medtronic, Ethicon, and Pacira and receiving personal fees from Medtronic, GI Dynamics, WL Gore and Associates, Becton Dickinson Surgical, and Global Academy for Medical Education. Dr Kattan reported receiving grants from Medtronic and Novo Nordisk. Dr Nissen reported receiving a grant from Medtronic for the current study and receiving research support from Amgen, AbbVie, AstraZeneca, Cerenis, Eli Lilly, Esperion Therapeutics, Novo-Nordisk, The Medicines Company, Orexigen, Pfizer, and Takeda and consulting for a number of pharmaceutical companies without financial compensation (all honoraria, consulting fees, or any other payments from any for-profit entity are paid directly to charity, so neither income nor any tax deduction is received). No other disclosures were reported.
Funding/Support: This study was partially funded by an unrestricted grant from Medtronic. Dr Arterburn was supported by National Institute of Diabetes and Digestive and Kidney Diseases grant R01-DK105960.
Role of the Funder/Sponsor: Medtronic had no role in the design and conduct of the study; collection, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.
Meeting Presentation: Presented at the European Society of Cardiology (ESC) Congress 2019; September 2, 2019; Paris, France.
Additional Contributions: We acknowledge Alex Milinovich, BA, and Jian Jin, MS, from Department of Quantitative Health Sciences, Cleveland Clinic, for creation of the database. Mssrs Milinovich and Jin did not receive compensation for their role in the study.
1.Ikramuddin
S, Korner
J, Lee
WJ,
et al. Lifestyle intervention and medical management with vs without Roux-en-Y gastric bypass and control of hemoglobin A
1c, LDL cholesterol, and systolic blood pressure at 5 years in the Diabetes Surgery Study.
JAMA. 2018;319(3):266-278. doi:
10.1001/jama.2017.20813PubMedGoogle ScholarCrossref 2.Mingrone
G, Panunzi
S, De Gaetano
A,
et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial.
Lancet. 2015;386(9997):964-973. doi:
10.1016/S0140-6736(15)00075-6PubMedGoogle ScholarCrossref 4.Johnson
BL, Blackhurst
DW, Latham
BB,
et al. Bariatric surgery is associated with a reduction in major macrovascular and microvascular complications in moderately to severely obese patients with type 2 diabetes mellitus.
J Am Coll Surg. 2013;216(4):545-556. doi:
10.1016/j.jamcollsurg.2012.12.019PubMedGoogle ScholarCrossref 5.Benotti
PN, Wood
GC, Carey
DJ,
et al. Gastric bypass surgery produces a durable reduction in cardiovascular disease risk factors and reduces the long-term risks of congestive heart failure.
J Am Heart Assoc. 2017;6(5):e005126. doi:
10.1161/JAHA.116.005126PubMedGoogle ScholarCrossref 6.Sjöström
L, Peltonen
M, Jacobson
P,
et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications.
JAMA. 2014;311(22):2297-2304. doi:
10.1001/jama.2014.5988PubMedGoogle ScholarCrossref 12.R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing website.
https://www.R-project.org/. 2018. Accessed August 20, 2019.
18.Chondronikola
M, Harris
LL, Klein
S. Bariatric surgery and type 2 diabetes: are there weight loss-independent therapeutic effects of upper gastrointestinal bypass?
J Intern Med. 2016;280(5):476-486. doi:
10.1111/joim.12527PubMedGoogle ScholarCrossref 23.Aggarwal
R, Harling
L, Efthimiou
E, Darzi
A, Athanasiou
T, Ashrafian
H. The effects of bariatric surgery on cardiac structure and function: a systematic review of cardiac imaging outcomes.
Obes Surg. 2016;26(5):1030-1040. doi:
10.1007/s11695-015-1866-5PubMedGoogle ScholarCrossref 24.Alonso
A, Bahnson
JL, Gaussoin
SA,
et al; Look AHEAD Research Group. Effect of an intensive lifestyle intervention on atrial fibrillation risk in individuals with type 2 diabetes: the Look AHEAD randomized trial.
Am Heart J. 2015;170(4):770-777.e5. doi:
10.1016/j.ahj.2015.07.026PubMedGoogle ScholarCrossref 29.Carlsson
LMS, Sjöholm
K, Karlsson
C,
et al. Long-term incidence of microvascular disease after bariatric surgery or usual care in patients with obesity, stratified by baseline glycaemic status: a post-hoc analysis of participants from the Swedish Obese Subjects study.
Lancet Diabetes Endocrinol. 2017;5(4):271-279. doi:
10.1016/S2213-8587(17)30061-XPubMedGoogle ScholarCrossref 30.O’Brien
R, Johnson
E, Haneuse
S,
et al. Microvascular outcomes in patients with diabetes after bariatric surgery versus usual care: a matched cohort study.
Ann Intern Med. 2018;169(5):300-310. doi:
10.7326/M17-2383PubMedGoogle ScholarCrossref