Influence of Body Mass Index on Long-Term Survival After Cardiac Catheterization
Autor: | Basheer Karkabi, David A. Halon, Ronen Jaffe, Ronen Rubinshtein, Barak Zafrir, Moshe Y. Flugelman |
---|---|
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Hazard ratio 030204 cardiovascular system & hematology Overweight Lower risk medicine.disease Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Cardiology 030212 general & internal medicine medicine.symptom Cardiology and Cardiovascular Medicine business Survival rate Body mass index Obesity paradox Cardiac catheterization |
Zdroj: | The American Journal of Cardiology. 121:113-119 |
ISSN: | 0002-9149 |
Popis: | We examined 18,654 patients who underwent cardiac catheterization in a single center to clarify the association between catheterization indication, body mass index (BMI), and long-term survival over a mean follow-up of 81 months. Patients were grouped by indication for catheterization: (a) acute coronary syndromes (ACS), 7,426 patients; (b) coronary artery disease (CAD) evaluation in stable clinical presentation, 6,911 patients; and (c) primarily non-CAD cardiac evaluations, 4,317 patients. Compared with normal weight, overweight and obesity (but not morbid obesity) was associated with lower risk of long-term mortality. Underweight patients had the greatest risk of mortality. After multivariate adjustment, survival benefit of the overweight and obese was retained in the ACS group [hazard ratio 0.86, 95% confidence interval (0.77-0.96), p = 0.006 and 0.79, (0.68-0.91), p = 0.001, respectively] and in overweight patients in the stable presentation CAD group [0.83, (0.72-0.94), p = 0.005], whereas there was no survival benefit in any of the BMI categories in those catheterized primarily for non-CAD indications. Further analysis of matched cohorts showed similar patterns of survival benefit of the overweight/obese. In conclusion, among patients who underwent cardiac catheterization, an inverse association between BMI and long-term mortality was observed, with the lowest risk noted in the overweight and obese population; the obesity paradox was principally demonstrated in patients with ACS, and was eliminated after covariate adjustment in those catheterized primarily for non-CAD indications. |
Databáze: | OpenAIRE |
Externí odkaz: |