Review article

Association of Body Mass Index With Major Cardiovascular Events and With Mortality After Percutaneous Coronary Intervention

Duk‐Woo ParkFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaYoung‐Hak KimFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaSung‐Cheol YunFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaJung‐Min AhnFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaJong‐Young LeeFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaWon-Jang KimFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaSoo‐Jin KangFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaSeung‐Whan LeeFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaCheol Whan LeeFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaSeong‐Wook ParkFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, KoreaSeung‐Jung ParkFrom the Departments of Cardiology, Asan Medical Center, (D.-W.P., Y.-H.K., J.-M.A., J.-Y.L., W.-J.K., S.-J.K., S.-W.L., C.W.L., S.-W.P., S.-J.P.), and Division of Biostatistics, Center for Medical Research and Information (S.-C.Y.), University of Ulsan College of Medicine, Seoul, Korea

2013en

ABI

Abstract

BACKGROUND: Conflicting data exist regarding the relation between body mass index (BMI) and cardiovascular events and mortality after percutaneous coronary intervention. METHODS AND RESULTS: We performed pooled analyses to evaluate the association between BMI (weight in kilograms divided by the square of the height in meters) and the risks of major cardiovascular events (defined as death from cardiovascular causes, nonfatal myocardial infarction, stent thrombosis, or stroke) and death among 23 181 patients from 11 prospective percutaneous coronary intervention studies. Overall, mean (±SD) BMI was 24.9±3.0. During follow-up (median, 2.1 years), 2381 patients had a major cardiovascular event, and 1004 patients died. After adjusting covariates, there was an inverse relationship between BMI and adverse outcomes. With a BMI of 22.5 to 24.9 as the reference category, the risk of major cardiovascular events was elevated among patients with a lower BMI (by a factor of 1.52 for a BMI <18.5; 1.05 for a BMI of 18.5-19.9; 1.03 for a BMI of 20.0-22.4); by contrast, the risk declined among patients with a higher BMI (by a factor of 0.97 for a BMI of 25.0-27.4; 0.97 for a BMI of 27.5-29.9; and 0.78 for a BMI of ≥30.0). In general, the hazard ratios for deaths were similar. CONCLUSIONS: Among patients undergoing percutaneous coronary intervention, a low BMI was associated with increased risks of major cardiovascular events and death. However, there were no excess risks of these events associated with a high BMI.

Identifiers

DOI: 10.1161/circinterventions.112.000062

Citations and references

Cited by 20 references

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