Can HF patients with obesity undergo metabolic, bariatric procedures?

Undergoing metabolic and bariatric procedures (MBP) is feasible in some adults with obesity and heart failure (HF), according to a study.

Individuals with HF who underwent MBPs at two medical centres were included in this multicentre retrospective cohort study from 2021 to 2023. The investigators examined 30-day safety events and changes in body weight and medication use among participants.

A total of 1,678 MBPs were identified, of which 41 (2.4 percent) were performed in adults with HF (mean age 51 years, 66 percent female, mean BMI 44 kg/m²).

At 30 days, patients with HF showed no significantly increased risk of any safety events than those without HF (24 percent vs 16 percent; adjusted odds ratio, 1.64, 95 percent confidence interval [CI], 0.76‒3.58; p=0.21) despite having older age and more obesity-related complications.

Likewise, change in body weight at 30 days did not differ significantly between patients with (‒5.9 percent, 95 percent CI, ‒6.9 to ‒4.9) and without HF (‒6.2 percent, 95 percent CI, ‒6.4 to ‒6.0; p=0.57 for comparison).

At 1 year, HF patients had significant reductions in body weight (mean change, ‒18.7 percent, 95 percent CI, ‒22.1 to ‒15.3; p<0.001), cardiovascular (p=0.003) and glucose-lowering medications (p<0.001), and loop diuretics (p=0.003).

“These findings suggest that MBPs are safe and effective in selected adults with obesity and established HF,” the investigators said. However, “[f]uture prospective studies in this population are warranted to enhance understanding of the benefits and risks of MBPs in persons with HF.”