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

Cardiovasc Ther. 2017 Aug;35(4). doi: 10.1111/1755-5922.12271.

Abstract

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.

Keywords: Body mass index; Outcomes; Percutaneous coronary angioplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian People
  • Body Mass Index*
  • China / epidemiology
  • Coronary Angiography
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Obesity / mortality
  • Percutaneous Coronary Intervention / mortality*
  • Prospective Studies
  • Survival Analysis
  • Treatment Outcome