European Heart Journal Advance Access published online on August 17, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp317
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Obesity paradox in a cohort of 4880 consecutive patients undergoing percutaneous coronary intervention
1 British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, UK
2 Section of Public Health, University of Glasgow, Room 305, Public Health Section, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
3 Monklands Hospital, Airdrie ML6 0JS, UK
4 West of Scotland Heart and Lung Centre, Glasgow G81 4HX, UK
5 Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
6 Aberdeen Royal Infirmary, Aberdeen AB25 2ZD, UK
7 Ninewells Hospital, Dundee DD1 9SY, UK
Received 7 January 2009; revised 22 May 2009; accepted 21 July 2009 * Corresponding author. Tel: +44 141 330 3239, Fax: +44 141 330 1874, Email: j.pell{at}clinmed.gla.ac.uk
Aims: We sought to investigate the impact of body mass index (BMI) on long-term all-cause mortality in patients following first-time elective percutaneous coronary intervention (PCI).
Methods and results: We used the Scottish Coronary Revascularisation Register to undertake a cohort study of all patients undergoing elective PCI in Scotland between April 1997 and March 2006 inclusive. We excluded patients who had previously undergone revascularization. There were 219 deaths within 5 years of 4880 procedures. Compared with normal weight individuals, those with a BMI
27.5 and <30 were at reduced risk of dying (HR 0.59, 95% CI 0.39–0.90, 95%, P = 0.014). There was no attenuation of the association after adjustment for potential confounders, including age, hypertension, diabetes, and left ventricular function (adjusted HR 0.59, 95% CI 0.39–0.90, P = 0.015), and there were no statistically significant interactions. The results were unaltered by restricting the analysis to events beyond 30 days of follow-up.
Conclusion: Among patients undergoing percutaneous intervention for coronary artery disease, increased BMI was associated with improved 5 year survival. Among those with established coronary disease, the adverse effects of excess adipose tissue may be offset by beneficial vasoactive properties.
Key Words: Angioplasty Body mass index Hypertension Mortality Obesity
![]()
CiteULike
Connotea
Del.icio.us What's this?
This article has been cited by other articles:
![]() |
W. Doehner, A. Clark, and S. D. Anker The obesity paradox: weighing the benefit Eur. Heart J., January 2, 2010; 31(2): 146 - 148. [Full Text] [PDF] |
||||
