Introduction:
Data regarding "obesity paradox" in patients with extreme obesity undergoing percutaneous coronary interventions (PCI) is limited and conflicting. We assessed clinical outcomes in patients with extreme obesity (Ex-Ob) compared to lean patients.
Methods:
From a single center prospective observational registry data, we assessed 1366 patients who underwent PCI from 01'-12'. We compared in-hospital and long term clinical outcomes between lean (body mass index (BMI ≤ 25kg/m2 , N=923) and Ex-Ob (BMI ≥40 kg/m2, N=443) patients.
Results:
The mean follow up duration was 3.6±2 yrs. Baseline characteristics are shown in table 1. Ex-Ob patients were younger, included fewer males and had higher frequency of cardiovascular co-morbidities (diabetes, hypertension, hyperlipidemia). There was no significant difference between the two groups with regards to in-hospital outcomes (death, major adverse cardiovascular events (MACE) or bleeding events). After multivariate adjustment for baseline differences, Ex-Ob patients had better long term overall (adj OR-0.63, 95%CI=0.41-0.95, p=0.029) and MACE free survival (adj OR-0.62, 95%CI=0.44 - 0.87, p=0.006) as compared to lean patients (Table 2 & Fig 1).
Conclusion:
Although there was no difference in short term outcomes, obesity paradox was observed in patients with extreme obesity with regards to long term clinical outcomes after PCI.
Long-term clinical outcomes of everolimus-eluting stent versus paclitaxel-eluting stent in patients undergoing percutaneous coronary interventions: a meta-analysis
