Obesity paradox in a cohort of 4880 consecutive patients undergoing percutaneous coronary intervention

Hastie, C. et al. (2010) Obesity paradox in a cohort of 4880 consecutive patients undergoing percutaneous coronary intervention. European Heart Journal, 31(2), pp. 222-226. (doi: 10.1093/eurheartj/ehp317)

Abstract

<b>Aims</b>: 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). <b>Methods and results</b>: 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. <b>Conclusion</b>: 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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hastie, Dr Claire and Jennings, Mr Kevin and Oldroyd, Dr Keith and Padmanabhan, Professor Sandosh and Dominiczak, Professor Anna and Eteiba, Professor Hany and Pell, Professor Jill
• Authors: Hastie, C., Padmanabhan, S., Slack, R., Pell, A.C.H., Oldroyd, K.G., Flapan, A.D., Jennings, K., Irving, J., Eteiba, H., Dominiczak, A.F., and Pell, J.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Centre for Population and Health Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: European Heart Journal
• ISSN: 0195-668X
• ISSN (Online): 1522-9645
• Published Online: 17 August 2009