The association of body mass index with long-term clinical outcomes after ticagrelor monotherapy following abbreviated dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: a prespecified sub-analysis of the GLOBAL LEADERS Trial

Figures

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  Fig. 1. Flowchart of the present study. Among 15,966 patients included in this analysis, 6973 (43.7%) had BMI < 27 kg/m2 and 8993 patients (56.3%) had BMI ≥ 27 kg/m2. Outcomes were assessed between experimental strategy and reference strategy in all-comers population, and furthermore in each clinical presentation (ACS and CCS). BMI body mass index, ACS acute coronary syndrome, CCS chronic coronary syndrome, ASA acetylsalicylic acid

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  Fig. 2. Histogram of BMI stratified by clinical presentation with adjusted hazard ratio for adverse events according to BMI. Blue and red bar graphs indicate the number of patients with BMI < 27 kg/m2 and ≥ 27 kg/m2 in the setting of ACS, respectively. Similarly, sky blue and orange bar graphs indicate the number of patients with BMI < 27 kg/m2 and ≥ 27 kg/m2 in the setting of CCS, respectively. Blue curve with light blue area indicates adjusted hazard ratio with 95% CI for composite of all-cause mortality and new Q-wave MI at 2-year according to BMI with reference of 27 kg/m2. Red curve with light red area indicates adjusted hazard ratio with 95% CI for BARC type 3 or 5 bleeding according to BMI with reference of 27 kg/m2. The number of knots for the cubic spline curves were three in each model. Adjusted covariates for all-cause mortality or new Q-wave MI are age (years), sex, clinical presentation (ACS or CCS), diabetes mellitus, hypertension, hypercholesteremia, PVD, COPD, renal impairment, previous MI, previous PCI, and previous CABG. Adjusted covariates for BARC type 3 or 5 bleeding are age (years), sex, clinical presentation (ACS or CCS), diabetes mellitus, previous bleeding, renal…

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  Fig. 3. Clinical outcomes at 2-year and forest plots in comparison of patients stratified according to BMI with threshold of 27 kg/m2. The squares indicate estimated hazard ratio, and the horizontal lines indicate 95% CI. There was no statistically significant difference in any clinical outcomes between experimental strategy and reference strategy in each BMI group (BMI < 27 kg/m2 or ≥ 27 kg/m2). pinteraction values were derived from Cox regression model. Abbreviations as in Fig. 2

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  Fig. 4. The 1-year landmark analysis and Kaplan–Meier curves in patients with ACS and either BMI < 27 kg/m2 or BMI ≥ 27 kg/m2. The 1-year landmark analyses of primary endpoint (all-cause mortality or new Q-wave MI), all-cause mortality, and secondary safety endpoint (BARC type 3, or 5 bleeding) have demonstrated that the reduced risks of adverse events in experimental arm compared to reference arm were largely obtained at 1 year in patients with ACS and BMI < 27 kg/m2. However, in patients with ACS and BMI ≥ 27 kg/m2, no treatment benefits were seen in terms of primary endpoint, all-cause mortality, and BARC type 3 or 5 bleeding, either in the first-year and up to 2 years from 1 year. Abbreviations as in Fig. 2