Key result
In patients who underwent percutaneous coronary intervention, a body mass index > 30 kg/m2 was associated with a reduced risk of all-cause mortality compared to normal weight (HR 0.57), whereas abdominal obesity was associated with a worse prognosis.
Why the study?
The study was conducted to investigate the impact of obesity, including body mass index and abdominal obesity, on clinical outcomes following percutaneous coronary intervention.
Does obesity and abdominal obesity affect all-cause mortality in patients undergoing percutaneous coronary intervention?
Cohort (n=130,490)
Does obesity and abdominal obesity affect all-cause mortality in patients undergoing percutaneous coronary intervention?
Hazard Ratio: 0.57 (95% CI 0.497–0.655)
Absolute Event Rate: 1.08% vs 2.4%
p-value: p=<0.0001
In patients undergoing PCI, mortality follows a U-shaped curve regarding BMI and waist circumference, with non-obese patients who have abdominal obesity facing the highest mortality risk.
Should not change post-PCI weight counseling; leaves open whether abdominal obesity refines risk models.
BACKGROUND/AIMS: We investigated the impact of obesity on the clinical outcomes following percutaneous coronary intervention (PCI). METHODS: We included South Koreans aged > 20 years who underwent the Korean National Health Screening assessment between 2009 and 2012. Obesity was defined using the body mass index (BMI), according to the World Health Organization's recommendations. Abdominal obesity was defined using the waist circumference (WC), as defined by the Korean Society for Obesity. The odds and hazard ratios in all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed up to the end of 2017. RESULTS: Among 130,490 subjects who underwent PCI, the mean age negatively correlated with BMI. WC, hypertension, diabetes, dyslipidemia, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels correlated with the increased BMI. The mortality rates were higher in the lower BMI and WC groups than the higher BMI and WC groups. The non-obese with abdominal obesity group showed a mortality rate of 2.11 per 1,000 person-years. Obese with no abdominal obesity group had the lowest mortality rate (0.88 per 1,000 person-years). The mortality showed U-shaped curve with a cut-off value of 29 in case of BMI and 78 cm of WC. CONCLUSION: The mortality showed U-shaped curve and the cut-off value of lowest mortality was 29 in case of BMI and 78 cm of WC. The abdominal obesity may be associated with poor prognosis in Korean patients who underwent PCI.
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Song et al. (2020) conducted a cohort in Coronary artery disease treated by percutaneous coronary intervention (n=130,490). Body mass index and waist circumference vs. Normal body mass index and waist circumference was evaluated on All-cause mortality (HR 0.57, 95% CI 0.497-0.655, p=<0.0001). In patients who underwent percutaneous coronary intervention, a body mass index > 30 kg/m2 was associated with a reduced risk of all-cause mortality compared to normal weight (HR 0.57), whereas abdominal obesity was associated with a worse prognosis.
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