Impact of Body Composition Indices on Ten-year Mortality After Revascularization of Complex Coronary Artery Disease (From the Syntax Extended Survival Trial)

被引：7

作者：

Ono, Masafumi ^{[1
,2
]}

Kawashima, Hideyuki ^{[1
,2
]}

Hara, Hironori ^{[1
,2
]}

O'Leary, Neil ^{[2
]}

Gao, Chao ^{[2
,3
]}

Wang, Rutao ^{[2
,3
]}

Takahashi, Kuniaki ^{[1
]}

Wykrzykowska, Joanna J. ^{[1
]}

Piek, Jan J. ^{[1
]}

Mack, Michael J. ^{[4
]}

Holmes, David R. ^{[5
]}

Morice, Marie-Claude ^{[6
]}

Head, Stuart J. ^{[7
]}

Kappetein, Arie Pieter ^{[7
]}

Thuijs, Daniel J. F. M. ^{[7
]}

Noack, Thilo ^{[8
]}

Friedrich, Mohr W. ^{[8
]}

Davierwala, Piroze M. ^{[8
]}

McEvoy, John W. ^{[2
]}

Onuma, Yoshinobu ^{[2
]}

Serruys, Patrick W. ^{[2
,9
]}

机构：

[1] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands

[2] Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland

[3] Radboud Univ Nijmegen, Dept Cardiol, Nijmegen, Netherlands

[4] Baylor Univ, Med Ctr, Dept Cardiothorac Surg, Dallas, TX USA

[5] Mayo Clin, Dept Cardiovasc Dis & Internal Med, Rochester, MN USA

[6] Hop Prive Jacques Cartier, Gen Sante Massy, Dept Cardiol, Massy, France

[7] Erasmus MC, Dept Cardiothorac Surg, Rotterdam, Netherlands

[8] Heart Ctr Leipzig, Univ Dept Cardiac Surg, Leipzig, Germany

[9] Imperial Coll London, NHLI, London, England

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2021年 / 151卷

关键词：

OBESITY PARADOX; CARDIORESPIRATORY FITNESS; MASS INDEX; INTERVENTION; BYPASS; ASSOCIATION; EVENTS;

D O I：

10.1016/j.amjcard.2021.04.008

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Numerous studies have demonstrated a paradoxical association between higher baseline body mass index (BMI) and lower long-term mortality risk after coronary revascularization, known as the "obesity paradox", possibly relying on the single use of BMI. The current study is a post-hoc analysis of the SYNTAX Extended Survival (SYNTAXES) trial, which is the extended follow-up of the SYNTAX trial comparing percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with left-main coronary artery disease (LMCAD) or three-vessel disease (3VD). Patients were stratified according to baseline BMI and/or waist circumference (WC). Out of 1,800 patients, 1,799 (99.9%) and 1,587 (88.2%) had available baseline BMI and WC data, respectively. Of those, 1,327 (73.8%) patients had High BMI (>= 25 kg/m(2)), whereas 705 (44.4%) patients had High WC (>102 cm for men or >88 cm for women). When stratified by both BMI and WC, 10-year mortality risk was significantly higher in patients with Low BMI/Low WC (adjusted hazard ratio [HR]: 1.65; 95% confidence interval [CI]: 1.09 to 2.51), Low BMI/ High WC (adjusted HR: 2.74; 95% CI: 1.12 to 6.69), or High BMI/High WC (adjusted HR: 1.59; 95% CI: 1.11 to 2.27) compared to those with High BMI/Low WC. In conclusion, the "obesity paradox" following coronary revascularization would be driven by low long-term mortality risk of the High BMI/Low WC group. Body composition should be assessed by the combination of BMI and WC in the appropriate evaluation of the long-term risk of obesity in patients with LMCAD or 3VD. (C) 2021 The Author(s). Published by Elsevier Inc.

引用

页码：30 / 38

页数：9

共 27 条

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