Impacto da obesidade nos resultados hospitalares da intervenção coronária percutânea: resultados do registro do hospital Bandeirantes

Abstract

Background: Obese patients may have better outcomes after percutaneous coronary intervention (PCI) compared to those with normal body mass index (BMI), the so-called "obesity paradox". This study was aimed at evaluating whether this paradox is observed in our country. Methods: This study included 4,957 consecutive patients submitted to PCI. Patients were classified as non-obese (BMI < 30 kg/m²) and obese (BMI > 30 kg/m²). Major adverse cardiac and cerebrovascular events (MACCE) were recorded at hospital discharge. Results: The obese group was three years younger, with a higher prevalence of risk factors for coronary artery disease, except for smoking. Clinical presentation was similar, with a predominance of stable coronary patients. Single vessel disease was the most frequent finding and the complexity of the lesions was not different between groups, except for calcified lesions, and left ventricular dysfunction was less frequent in the obese group. Stent diameter and length were similar between groups. Procedure success rate was high and similar for obese and non-obese patients. At hospital discharge, the incidence of MACCE (2.5% vs. 2.7%; P = 0.76), in-hospital death (1% vs. 1.1%; P = 0.88), stroke (0.1% vs. 0.1%; P = 0.79), acute myocardial infarction (1.6% vs. 1.8%; P = 0.74) and emergency CABG (0 vs. 0.1%; P = 0.35) was not different between groups. Age, diabetes, hypertension and type B2/C lesions were the variables that best explained MACCE. Conclusions: In patients with coronary artery disease undergoing PCI, BMI > 30 kg/m² did not influence the risk of procedure-related in-hospital clinical events.

Fatores De Risco Associados Ao Infarto Agudo Do Miocárdio

“…O consumo exagerado de alimentos gordurosos e açucares estão relacionados ao aumento da obesidade e ao desenvolvimento de doenças cardiovasculares. Silveira et al, (2016); Barroso et al, (2017) e Coelho et al, (2011), corroboram com a mesma teoria onde a obesidade é um fator para o desenvolvimento de doenças do aparelho cardiovascular, a obesidade pode ser definida como um padrão de massa corporal, tendo um crescimento de forma epidêmica na sociedade, favorecendo assim, o surgimento das doenças cardiovasculares por estar dentro de processos metabólicos associados a diversos fatores de riscos. Entretanto, muitos estudos têm apontado um "paradoxo da obesidade", onde a obesidade parece ser protetora contra um parece adverso, marcando uma diminuição da mortalidade intra-hospitalar e a um grande prazo.…”