Impact of Body Mass Index on the Clinical Outcomes after Percutaneous Coronary Intervention in Patients ≥75 Years Old

被引：0

作者：

He PeiYuan ^{[1
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Yang YueJin

Qiao ShuBin ^{[1
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Xu Bo ^{[1
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Yao Min ^{[1
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Wu YongJian ^{[1
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Wu Yuan ^{[1
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Yuan JinQing ^{[1
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Chen Jue ^{[1
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Liu HaiBo ^{[1
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Dai Jun ^{[1
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Li Wei ^{[7
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Tang YiDa ^{[1
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Yang JinGang ^{[1
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Gao RunLin ^{[1
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机构：

[1] Department of Cardiology

[2] Cardiovascular Institute and Fuwai Hospital

[3] National Center for Cardiovascular Diseases

[4] Chinese Academy of Medical Sciences and Peking Union Medical College

[5] Beijing

[6] China

[7] Medical Research and Biometrics Center

来源：

中华医学杂志英文版 | 2015年 / 128卷 / 05期

关键词：

Aged; Angioplasty; Body Mass Index; Outcomes;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The impact of body mass index (BMI) on the clinical outcomes after percutaneous coronary intervention (PCI) in patients ≥75 years old remained unclear.Methods: A total of 1098 elderly patients undergoing PCI with stent implantation were recruited. Patients were divided into four groups by the value of BMI: Underweight (≤20.0 kg/m2), normal weight (20.0–24.9 kg/m2), overweight (25.0–29.9 kg/m2) and obese (≥30.0 kg/m2). Major clinical outcomes after PCI were compared between the groups. The primary endpoint was defined as in-hospital major adverse cardiovascular events (MACEs), which included death, myocardial infarction (MI) and target vessel revascularization. The secondary endpoint was defined as 1 year death. Logistic regression analysis was performed to adjust for the potential confounders.Results: Totally, 1077 elderly patients with available BMIs were included in the analysis. Patients of underweight, normal weight, overweight and obese accounted for 5.6%, 45.4%, 41.5% and 7.5% of the population, respectively. Underweight patients were more likely to attract ST-segment elevation MI, and get accompanied with anemia or renal dysfunction. Meanwhile, they were less likely to achieve thrombolysis in MI 3 grade flow after PCI, and receive beta-blocker, angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge. In underweight, normal weight, overweight and obese patients, in-hospital MACE were 1.7%, 2.7%, 3.8%, and 3.7% respectively (P = 0.68), and 1 year mortality rates were 5.0%, 3.9%, 5.1% and 3.7% (P = 0.80), without significant difference between the groups. Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old.Conclusions: The BMI "obese paradox" was not found in patients ≥75 years old. It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients.

引用

页码：638 / 643

页数：6

共 22 条

[11]

Medical Therapies and Invasive Treatments for Coronary Artery Disease by Body Mass: The “Obesity Paradox” in the Get With The Guidelines Database[J] . Benjamin A. Steinberg,Christopher P. Cannon,Adrian F. Hernandez,Wenqin Pan,Eric D. Peterson,Gregg C. Fonarow.The American Journal of Cardiology . 2007 (9)

[12] Impact of body mass index on outcomes after percutaneous coronary intervention in patients with acute myocardial infarction [J].

Mehta, Laxmi ;

Devlin, William ;

McCullough, Peter A. ;

O'Neill, William W. ;

Skelding, Kimberly A. ;

Stone, Gregg W. ;

Boura, Judith A. ;

Grines, Cindy L. .

AMERICAN JOURNAL OF CARDIOLOGY, 2007, 99 (07) :906-910

[13]

The Relationship of Body Mass Index to Outcomes after Percutaneous Coronary Intervention[J] . MAMDOUH M.SHUBAIR,POORNIMAPRABHAKARAN,VIKTORIAPAVLOVA,JAMES L.VELIANOU,ARYA M.SHARMA,MADHU K.NATARAJAN.Journal of Interventional Cardiology . 2006 (5)

[14]

Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies[J] . Abel Romero-Corral,Victor M Montori,Virend K Somers,Josef Korinek,Randal J Thomas,Thomas G Allison,Farouk Mookadam,Francisco Lopez-Jimenez.The Lancet . 2006 (9536)

[15]

The obesity paradox in non–ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association Guidelines Quality Improvement Initiative[J] . Deborah B. Diercks,Matthew T. Roe,Jyotsna Mulgund,Charles V. Pollack,J. Douglas Kirk,W. Brian Gibler,E. Magnus Ohman,Sidney C. Smith,William E. Boden,Eric D. Peterson.American Heart Journ

[16] Obesity as compared with physical activity in predicting risk of coronary heart disease in women [J].

Li, TY ;

Rana, JS ;

Manson, JE ;

Willett, WC ;

Stampfer, MJ ;

Colditz, GA ;

Rexrode, KM ;

Hu, FB .

CIRCULATION, 2006, 113 (04) :499-506

[17]

Impact of body mass index on outcomes after primary angioplasty in acute myocardial infarction[J] . Eugenia Nikolsky,Gregg W. Stone,Cindy L. Grines,David A. Cox,Eulogio Garcia,James E. Tcheng,John J. Griffin,Giulio Guagliumi,Thomas Stuckey,Mark Turco,Manuela Negoita,Alexandra J. Lansky,Roxana Mehran.American Heart Journal . 2005 (1)

[18]

Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study[J] . Salim Yusuf,Steven Hawken,Stephanie ?unpuu,Leonelo Bautista,Maria Grazia Franzosi,Patrick Commerford,Chim C Lang,Zvonko Rumboldt,Churchill L Onen,Liu Lisheng,Supachai Tanomsup,Paul Wangai,Fahad Razak,Arya M Sharma,Sonia S Anand.The Lancet . 2005 (9497)

[19]

Impact of body mass index on In-Hospital outcomes following percutaneous coronary intervention （report from the New York State Angioplasty Registry） 1 1 *This study was performed with the permission of the New York State Department of Health, which retains ownership of the registry[J] . Robert M Minutello,Eric T Chou,Mun K Hong,Geoffrey Bergman,Manish Parikh,Frank Iacovone,S.Chiu Wong.The American Journal of Cardiology . 2004 (10)

[20]

The impact of obesity on the short-term andlong-term outcomes after percutaneous coronary intervention: the obesity paradox?[J] . Luis Gruberg.Journal of the American College of Cardiology . 2002 (4)

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