The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: The obesity paradox?
The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: The obesity paradox?
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DOI：
10.1016/s0735-1097(01)01802-2
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发表时间：
2002-02-20
影响因子：
24
通讯作者：
Lindsay, J
中科院分区：
文献类型：
--
作者：
Gruberg, L;Weissman, NJ;Lindsay, J
目的探讨体重指数(BMI)对经皮冠状动脉介入治疗(PCI)术后近期和远期预后的影响。然而，体重指数与经皮冠状动脉介入治疗的预后之间的关系仍然存在争议。按体重指数分为3组：正常组1,923例，体重指数在18.5~24.9之间者1,923例；超重者4,813例，体重指数在25~30之间者4,813例；肥胖组2,897例，体重指数<30岁者2,897例。结果肥胖者年龄明显小于正常体重者和超重者，且其高血压、糖尿病、高胆固醇血症和吸烟史的发生率明显高于正常体重者和超重者(P<；0.0001)。尽管三组患者的血管造影成功率相似，但体重指数正常的患者的主要住院并发症的发生率更高，包括心源性死亡(p=0.001)，在一年的随访中，体重指数正常的患者的总体死亡率显著高于超重或肥胖患者(p<；0.0001)。心肌梗死和血运重建率在三组之间没有差异。经多因素COX回归分析，糖尿病、高血压、年龄、BMI和左心功能是长期死亡率的独立预测因素。结论已知的冠心病患者、非常瘦的患者(BMI和lt；18.5)和BMI在正常范围内的患者住院期间并发症和心源性死亡的风险最高，一年死亡率增加。(C)2002年，由美国心脏病学会提供。
OBJECTIVES The purpose of this study was to assess the impact of body mass index (BMI) on the short-and long-term outcomes after percutaneous coronary intervention (PCI).BACKGROUND Obesity is associated with advanced coronary artery disease (CAD). However, the relation between BMI and outcome after PCI remains controversial.METHODS We studied 9,633 consecutive patients who underwent PCI between January 1994 and December 1999. Patients were divided into three groups according to BMI: normal, BMI between 18.5 and 24.9 (n = 1,923); overweight, BMI between 25 and 30 (n = 4,813); and obese, BMI >30 (n = 2,897).RESULTS Obese patients were significantly younger and had consistently worse baseline clinical characteristics than normal or overweight patients, with a higher incidence of hypertension, diabetes, hypercholesterolemia and smoking history (p < 0.0001). Despite similar angiographic success rates among the three groups, normal BMI patients had a higher incidence of major in-hospital complications, including cardiac death (p = 0.001), At one-year follow-up, overall mortality rates were significantly higher for normal BMI patients compared with overweight or obese patients (p < 0.0001). Myocardial infarction and revascularization rates did not differ among the three groups. By multivariate Cox regression analysis, diabetes, hypertension, age, BMI and left ventricular function were independent predictors of long-term mortality.CONCLUSIONS In patients with known CAD who undergo PCI, very lean patients (BMI < 18.5) and those with BMI within the normal range are at the highest risk for in-hospital complications and cardiac death and for increased one-year mortality. (C) 2002 by the American College of Cardiology.