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Differences in Short- and Long-Term Mortality Associated With BMI Following Coronary Revascularization
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نویسنده
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terada t. ,forhan m. ,norris c.m. ,qiu w. ,padwal r. ,sharma a.m. ,nagendran j. ,johnson j.a.
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منبع
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journal of the american heart association - 2017 - دوره : 6 - شماره : 4
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چکیده
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Background: the association between obesity and mortality risks following coronary revascularization is not clear. we examined the associations of bmi (kg/m2) with short-,intermediate-,and long-term mortality following coronary artery bypass graft surgery (cabg) and percutaneous coronary intervention (pci) in patients with different coronary anatomy risks and diabetes mellitus status.methods and results: data from the alberta provincial project for outcomes assessment in coronary heart disease (approach) registry were analyzed. using normal bmi (18.5-24.9) as a reference,multivariable-adjusted hazard ratios for all-cause mortality within 6 months,1 year,5 years,and 10 years were individually calculated for cabg and pci with 4 prespecified bmi categories: overweight (25.0-29.9),obese class i (30.0-34.9),obese class ii (35.0-39.9),and obese class iii (≥40.0). the analyses were repeated after stratifying for coronary risks and diabetes mellitus status. the cohorts included 7560 and 30 258 patients for cabg and pci,respectively. following pci,overall mortality was lower in patients with overweight and obese class i compared to those with normal bmi; however,5- and 10-year mortality rates were significantly higher in patients with obese class iii with high-risk coronary anatomy,which was primarily driven by higher mortality rates in patients without diabetes mellitus (5-year adjusted hazard ratio,1.78 [95% ci,1.11-2.85] and 10-year adjusted hazard ratio,1.57 [95% ci,1.02-2.43]). following cabg,overweight was associated with lower mortality risks compared with normal bmi.conclusions: overweight was associated with lower mortality following cabg and pci. greater long-term mortality in patients with obese class iii following pci,especially in those with high-risk coronary anatomy without diabetes mellitus,warrants further investigation. © 2017 the authors. published on behalf of the american heart association,inc.,by wiley.
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کلیدواژه
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cardiovascular disease; coronary artery bypass graft surgery; diabetes mellitus; obesity; percutaneous coronary intervention
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آدرس
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department of occupational therapy,faculty of rehabilitation medicine,university of alberta,edmonton,alberta, Canada, department of occupational therapy,faculty of rehabilitation medicine,university of alberta,edmonton,alberta, Canada, school of public health,university of alberta,edmonton,alberta,canada,faculty of nursing,university of alberta,edmonton,alberta,canada,department of medicine,faculty of medicine and dentistry,university of alberta,edmonton,alberta,canada,alberta transplant institute,university of alberta,edmonton,alberta,canada,cardiovascular health and stroke strategic clinical network,alberta health services,edmonton,canada,department of surgery,mazankowski alberta heart institute,alberta health services,edmonton, Canada, school of public health,university of alberta,edmonton,alberta, Canada, department of medicine,faculty of medicine and dentistry,university of alberta,edmonton,alberta, Canada, department of medicine,faculty of medicine and dentistry,university of alberta,edmonton,alberta, Canada, alberta transplant institute,university of alberta,edmonton,alberta,canada,department of surgery,mazankowski alberta heart institute,alberta health services,edmonton, Canada, school of public health,university of alberta,edmonton,alberta, Canada
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Authors
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