Impact of body mass index on the five-year outcome of patients having percutaneous coronary interventions with drug-eluting stents

Sarno, Giovanna; Räber, Lorenz; Onuma, Yoshinobu; Garg, Scot; Brugaletta, Salvatore; van Domburg, Ron T; Pilgrim, Thomas; Pfäffli, Nico; Wenaweser, Peter; Windecker, Stephan; Serruys, Patrick (2011). Impact of body mass index on the five-year outcome of patients having percutaneous coronary interventions with drug-eluting stents. American journal of cardiology, 108(2), pp. 195-201. New York, N.Y.: Elsevier 10.1016/j.amjcard.2011.03.023

Full text not available from this repository.

The purpose of this study was to assess the impact of body mass index (BMI) on clinical outcome of patients treated by percutaneous coronary intervention (PCI) using drug-eluting stents. Patients were stratified according to BMI as normal (<25 kg/m(2)), overweight (25 to 30 kg/m(2)), or obese (>30 kg/m(2)). At 5-year follow-up all-cause death, myocardial infarction, clinically justified target vessel revascularization (TVR), and definite stent thrombosis were assessed. A complete dataset was available in 7,427 patients, of which 45%, 22%, and 33% were classified according to BMI as overweight, obese, and normal, respectively. Mean age of patients was significantly older in those with a normal BMI (p <0.05). Incidence of diabetes mellitus, hypertension, and dyslipidemia increased as BMI increased (p <0.05). Significantly higher rates of TVR (15.3% vs 12.8%, p = 0.02) and early stent thrombosis (1.5% vs 0.9%, p = 0.04) were observed in the obese compared to the normal BMI group. No significant difference among the 3 BMI groups was observed for the composite of death/myocardial infarction/TVR or for definite stent thrombosis at 5 years, whereas the normal BMI group was at higher risk for all-cause death at 5 years (obese vs normal BMI, hazard ratio 0.74, confidence interval 0.53 to 0.99, p = 0.05; overweight vs normal BMI, hazard ratio 0.73, confidence interval 0.59 to 0.94, p = 0.01) in the multivariate Cox proportional hazard model. Age resulted in a linearly dependent covariate with BMI in the all-cause 5-year mortality multivariate model (p = 0.001). In conclusion, the "obesity paradox" observed in 5-year all-cause mortality could be explained by the higher rate of elderly patients in the normal BMI group and the existence of colinearity between BMI and age. However, obese patients had a higher rate of TVR and early stent thrombosis and a higher rate of other risk factors such as diabetes mellitus, hypertension, and hypercholesterolemia.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Räber, Lorenz, Pilgrim, Thomas, Wenaweser, Peter Martin, Windecker, Stephan
ISSN:	0002-9149
Publisher:	Elsevier
Language:	English
Submitter:	Lorenz Räber
Date Deposited:	04 Oct 2013 14:21
Last Modified:	05 Dec 2022 14:06
Publisher DOI:	10.1016/j.amjcard.2011.03.023
PubMed ID:	21529741
Web of Science ID:	000294031500005
URI:	https://boris.unibe.ch/id/eprint/7227 (FactScience: 212414)