Low body mass index,serum creatinine,and cause of death in patients undergoing percutaneous coronary intervention

Background-low body mass index (bmi) and serum creatinine are surrogate markers of frailty and sarcopenia. their relationship with cause-specific mortality in elderly patients undergoing percutaneous coronary intervention is not well studied. methods and results-we determined long-term cardiovascular and noncardiovascular mortality in 9394 consecutive patients aged ≥65 years who underwent percutaneous coronary intervention from 2000 to 2011. bmi and serum creatinine were divided into 4 categories. during a median follow-up of 4.2 years (interquartile range 1.8-7.3 years),3243 patients (33.4%) died. in the multivariable model,compared with patients with normal bmi,patients with low bmi had significantly increased all-cause mortality (hazard ratio [hr] 1.4,95% ci 1.1-1.7),which was related to both cardiovascular causes (hr 1.4,95% ci 1.0-1.8) and noncardiovascular causes (hr 1.4,95% ci 1.06-1.9). compared with normal bmi,significant reduction was noted in patients who were overweight and obese in terms of cardiovascular mortality (overweight: hr 0.77,95% ci 0.67-0.88; obese: hr 0.80,95% ci 0.70-0.93) and noncardiovascular mortality (overweight: hr 0.85,95% ci 0.74-0.97; obese: hr 0.82,95% ci 0.72-0.95). in a multivariable model,in patients with normal bmi,low creatinine (≤0.70 mg/dl) was significantly associated with increased all-cause mortality (hr 1.8,95% ci 1.3-2.5) and cardiovascular mortality (hr 2.3,95% ci 1.4-3.8) compared with patients with normal creatinine (0.71-1.0 mg/dl); however,this was not observed in other bmi categories. conclusions-we identified a new subgroup of patients with low serum creatinine and normal bmi that was associated with increased all-cause mortality and cardiovascular mortality in elderly patients undergoing percutaneous coronary intervention. low bmi was associated with increased cardiovascular and noncardiovascular mortality. nutritional support,resistance training,and weight-gain strategies may have potential roles for these patients undergoing percutaneous coronary intervention. © 2016 the authors.