Skip to main content

Research Repository

Advanced Search

The relationship of body mass index to percutaneous coronary intervention outcomes: Does the obesity paradox exist in contemporary PCI cohorts? Insights from the British Cardiovascular Intervention Society registry.

Mamas

Authors



Abstract

Objectives
The aims of this study were to examine the relationship between body mass index (BMI) and clinical outcomes following percutaneous coronary intervention (PCI) and to determine the relevance of different clinical presentations requiring PCI to this relationship.

Background
Obesity is a growing problem, and studies have reported a protective effect from obesity compared with normal BMI for adverse outcomes after PCI.

Methods
Between 2005 and 2013, 345,192 participants were included. Data were obtained from the British Cardiovascular Intervention Society registry, and mortality data were obtained through the U.K. Office of National Statistics. Multiple logistic regression was performed to determine the association between BMI group (<18.5, 18.5 to 24.9, 25 to 30 and >30 kg/m2) and adverse in-hospital outcomes and mortality.

Results
At 30 days post-PCI, significantly lower mortality was seen in patients with elevated BMIs (odds ratio [OR]: 0.86 [95% confidence interval (CI): 0.80 to 0.93] 0.90 [95% CI: 0.82 to 0.98] for BMI 25 to 30 and >30 kg/m2, respectively). At 1 year post-PCI, and up to 5 years post-PCI, elevated BMI (either overweight or obese) was an independent predictor of greater survival compared with normal weight (OR: 0.70 [95% CI: 0.67 to 0.73] and 0.73 [95% CI: 0.69 to 0.77], respectively, for 1 year; OR: 0.78 [95% CI: 0.75 to 0.81] and 0.88 [95% CI: 0.84 to 0.92], respectively, for 5 years). Similar reductions in mortality were observed for the analysis according to clinical presentation (stable angina, unstable angina or non–ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction).

Conclusions
A paradox regarding the independent association of elevated BMI with reduced mortality after PCI is still evident in contemporary U.K. practice. This is seen in both stable and more acute clinical settings.

Citation

Mamas. (2017). The relationship of body mass index to percutaneous coronary intervention outcomes: Does the obesity paradox exist in contemporary PCI cohorts? Insights from the British Cardiovascular Intervention Society registry. JACC. Cardiovascular interventions, 1283-1292. https://doi.org/10.1016/j.jcin.2017.03.013

Acceptance Date Mar 9, 2017
Publication Date Jul 3, 2017
Journal JACC: Cardiovascular Interventions
Print ISSN 1876-7605
Pages 1283-1292
DOI https://doi.org/10.1016/j.jcin.2017.03.013
Keywords body mass index, obesity, percutaneous coronary intervention, mortality, cardiovascular events
Publisher URL http://www.sciencedirect.com/science/article/pii/S1936879817305435