Association of body mass index with mortality in Chinese patients after percutaneous coronary intervention: A large single‐center data

Summary Background Although numerous studies, to date, have demonstrated a specific phenomenon called the “obesity paradox” in patients after percutaneous coronary intervention (PCI), studies performed in China thus far have consistently shown an absence of this phenomenon. Hypothesis “Obesity paradox” does exist in Chinese PCI patients. Methods 10 724 consecutive Chinese patients who had undergone PCI treatment at a single center from January 2013 to December 2013 were prospectively recruited. Patients were divided into four groups: underweight (body mass index [BMI<18.5 kg/m2]), normal weight (18.5 kg/m2≤BMI<24.0 kg/m2), overweight (24.0 kg/m2≤BMI<28.0 kg/m2), and obese (BMI≥28.0 kg/m2). Two‐year clinical outcomes were compared across the groups. Results Overall, mean (±SD) BMI of all the patients was 25.9±3.2 kg/m2. The 2‐year mortality across underweight, normal weight, overweight, and obese patients in different BMI groups was 2.2%, 1.7%, 1.1%, and 1.0%, respectively (P=.035). Kaplan‐Meier curves revealed that normal weight patients had higher incidence of all‐cause mortality than overweight and obese (P=.015 and P=.020, respectively). Multivariable Cox regression analysis indicated that overweight was an independent predictor of all‐cause mortality compared with normal weight (HR 0.64, 95% CI 0.41‐0.98, P=.042). Conclusions Overweight patients have lower risk of mortality after PCI treatment; therefore, the phenomenon of “obesity paradox” also seems to exist in Chinese PCI patients.