Mortality is lowest in overweight followed by obese and morbid obese patients and is highest in cachexia compared to normal weight in patients with the diagnosis of aortic stenosis.

Abstract

Introduction: The obesity paradox has been seen in many cardiovascular conditions. The goal of this study was to evaluate whether it exists in patients with a diagnosis of aortic stenosis. Method: We used the Nationwide Inpatients Sample (NIS) database and ICD-10 coding for adults in different weight categories and with aortic stenosis diagnoses for 2016-2020. We evaluated the effect of weight on mortality using multivariate adjustment and the cox-regression model. Results: A total of 2,330,584 patients were diagnosed with aortic stenosis. Mortality was lowest in overweight followed by obesity and morbid obesity (1.74% vs. 2.43% vs 3.2% in comparison to normal weight mortality of 4.4%, p<0.001) and it was highest in patients with cachexia (mortality of 14.5%). After adjusting for baseline characteristics and comorbid conditions, the relation between mortality and weights remained unaltered. Multivariate adjusted odds ratios (OR) were as follows: Overweight OR 0.4, CI 0.31-0.6, p<0.001, Obesity: OR 0.64, CI 06-0.68, p<0.001, morbid obesity OR: 0.88, CI 0.83-0.94, P<0.001, Cachexia OR 3.31 CI: 3.04-3.62, p<0.001). Conclusion: Using the largest database, we found that in patients with a diagnosis of aortic stenosis, overweight followed by obesity and morbid obesity have the lowest mortality whereas cachexia has the highest mortality compared to normal-weight patients.