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Background <p>Although metabolic and bariatric surgery (MBS) is an established treatment for obesity, its effects on cardiac electrophysiology remain poorly characterized. This study investigated whether MBS was associated with a reduced risk of QTc interval prolongation in female patients with severe obesity.</p> Methods <p>This retrospective cohort study utilized the TriNetX database to identify female adults with body mass index ≥ 40&#xa0;kg/m² who underwent laparoscopic surgery between 2010 and 2023. Patients were stratified into MBS (sleeve gastrectomy or gastric bypass) and control groups (other laparoscopic procedures). We performed 1:1 propensity score matching based on demographics, comorbidities, and laboratory parameters. The primary outcome was the incidence of QTc prolongation (≥ 460 ms) at one-year follow-up. Secondary analyses assessed outcomes at three months and three years to evaluate temporal trends. A prespecified subgroup analysis examined whether the effects differed by surgical technique.</p> Results <p>Among 79,796 matched female patients (39,898 per group), MBS was associated with a significantly reduced QTc prolongation cumulative incidence within one year (0.33% vs. 0.77%; Hazard ratio [HR]: 0.41, 95% confidence interval [CI]: 0.33–0.50, <i>p</i> &lt; 0.001). This association remained consistent across follow-up (HRs 0.47 at three months; 0.39 at three years). The association between procedure type and QTc prolongation differed in magnitude, with sleeve gastrectomy showing a lower HR than gastric bypass (0.34 vs. 0.61, p for subgroup difference = 0.005).</p> Conclusion <p>MBS confers a sustained three-year reduction in QTc prolongation risk in female patients with severe obesity, likely reflecting the cardiovascular benefits of weight loss and metabolic recovery, though individual contributions cannot be separated.</p>

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Reduced Incidence of QTc Prolongation Following Metabolic and Bariatric Surgery in Female Patients: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年11月21日

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  • Kuo-Chuan Hung,
  • Hsiu-Lan Weng,
  • Chun-Ning Ho,
  • I-Wen Chen

摘要

Background

Although metabolic and bariatric surgery (MBS) is an established treatment for obesity, its effects on cardiac electrophysiology remain poorly characterized. This study investigated whether MBS was associated with a reduced risk of QTc interval prolongation in female patients with severe obesity.

Methods

This retrospective cohort study utilized the TriNetX database to identify female adults with body mass index ≥ 40 kg/m² who underwent laparoscopic surgery between 2010 and 2023. Patients were stratified into MBS (sleeve gastrectomy or gastric bypass) and control groups (other laparoscopic procedures). We performed 1:1 propensity score matching based on demographics, comorbidities, and laboratory parameters. The primary outcome was the incidence of QTc prolongation (≥ 460 ms) at one-year follow-up. Secondary analyses assessed outcomes at three months and three years to evaluate temporal trends. A prespecified subgroup analysis examined whether the effects differed by surgical technique.

Results

Among 79,796 matched female patients (39,898 per group), MBS was associated with a significantly reduced QTc prolongation cumulative incidence within one year (0.33% vs. 0.77%; Hazard ratio [HR]: 0.41, 95% confidence interval [CI]: 0.33–0.50, p < 0.001). This association remained consistent across follow-up (HRs 0.47 at three months; 0.39 at three years). The association between procedure type and QTc prolongation differed in magnitude, with sleeve gastrectomy showing a lower HR than gastric bypass (0.34 vs. 0.61, p for subgroup difference = 0.005).

Conclusion

MBS confers a sustained three-year reduction in QTc prolongation risk in female patients with severe obesity, likely reflecting the cardiovascular benefits of weight loss and metabolic recovery, though individual contributions cannot be separated.