Association of Body Mass Index and Clinical Outcomes in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention.

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta Cardiologica Sinica Pub Date : 2025-01-01 DOI:10.6515/ACS.202501_41(1).20241021B

Ting-Yu Lin, Hsin-Bang Leu

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引用次数: 0

Abstract

Background: The obesity paradox refers to lower mortality rates among overweight or obese individuals within certain populations. However, whether this paradox is applicable to patients undergoing percutaneous coronary intervention (PCI) remains unclear.

Methods: A total of 5,427 patients with coronary artery disease (CAD) who underwent successful PCI between 2005 and 2015 were enrolled. The association between body mass index (BMI) and future adverse cardiovascular events post PCI was analyzed. The study endpoints encompassed total cardiovascular (CV) events, including cardiac death, nonfatal myocardial infarction (MI), ischemic stroke, and hospitalization for congestive heart failure (CHF).

Results: Over an average follow-up period of 65.1 ± 32.1 months, 942 patients (17.4%) had CV events, including 200 CV deaths (3.7%), 294 acute MIs (5.4%), 111 ischemic strokes (2.0%), 469 CHF hospitalizations (8.6%), and 1,098 revascularizations (20.2%). A J-shaped relationship between BMI and future adverse events was observed, in which individuals with a BMI of 25.0-29.9 kg/m² had significantly lower risks of total CV events [hazard ratio (HR) = 0.84, 95% confidence interval (CI) = 0.72-0.98], major adverse cardiovascular events (HR = 0.76, 95% CI = 0.63-0.93), acute MI (HR = 0.76, 95% CI = 0.58-1.00), and ischemic stroke (HR = 0.61, 95% CI = 0.39-0.95), compared to those with a BMI of 22.0-24.9 kg/m².

Conclusions: We found a J-shaped relationship between baseline BMI and future adverse events in CAD patients undergoing PCI. Overweight individuals (BMI 25.0-29.9 kg/m²) had the lowest future risk of total CV events compared to those with a normal BMI (22.0-24.9 kg/m²).

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经皮冠状动脉介入治疗的冠心病患者体重指数与临床结果的关系

背景：肥胖悖论是指某些人群中超重或肥胖个体的死亡率较低。然而，这一悖论是否适用于经皮冠状动脉介入治疗（PCI）的患者尚不清楚。方法：入选2005 - 2015年间行PCI成功的5427例冠心病（CAD）患者。分析PCI术后体重指数（BMI）与未来不良心血管事件的关系。研究终点包括总心血管（CV）事件，包括心源性死亡、非致死性心肌梗死（MI）、缺血性中风和因充血性心力衰竭（CHF）住院。结果：在平均65.1±32.1个月的随访期间，942例（17.4%）患者发生CV事件，包括200例CV死亡（3.7%）、294例急性MIs（5.4%）、111例缺血性卒中（2.0%）、469例CHF住院（8.6%）和1098例血运重建（20.2%）。BMI与未来不良事件之间呈j型关系，BMI为25.0 ~ 29.9 kg/m2的个体发生总心血管事件的风险[风险比(HR) = 0.84, 95%可信区间(CI) = 0.72 ~ 0.98]、主要心血管不良事件（HR = 0.76, 95% CI = 0.63 ~ 0.93）、急性心肌梗死（HR = 0.76, 95% CI = 0.58 ~ 1.00）和缺血性卒中（HR = 0.61, 95% CI = 0.39 ~ 0.95）的风险显著低于BMI为22.0 ~ 24.9 kg/m2的个体。结论：我们发现基线BMI与接受PCI的CAD患者未来不良事件之间呈j型关系。与BMI正常（22.0-24.9 kg/m2）的个体相比，超重个体（BMI 25.0-29.9 kg/m2）未来总CV事件的风险最低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Cardiologica Sinica 医学-心血管系统

CiteScore

2.90

自引率

15.80%

发文量

144

审稿时长

>12 weeks

期刊介绍： Acta Cardiologica Sinica welcomes all the papers in the fields related to cardiovascular medicine including basic research, vascular biology, clinical pharmacology, clinical trial, critical care medicine, coronary artery disease, interventional cardiology, arrythmia and electrophysiology, atherosclerosis, hypertension, cardiomyopathy and heart failure, valvular and structure cardiac disease, pediatric cardiology, cardiovascular surgery, and so on. We received papers from more than 20 countries and areas of the world. Currently, 40% of the papers were submitted to Acta Cardiologica Sinica from Taiwan, 20% from China, and 20% from the other countries and areas in the world. The acceptance rate for publication was around 50% in general.