Impact of body mass index on the outcome of patients with multivessel disease randomized to either coronary artery bypass grafting or stenting in the ARTS trial: The obesity paradox II?

Gruberg, Luis; Mercado, Nestor; Milo, Simcha; Boersma, Eric; Disco, Clemens; Es, Gerrit Anne van; Lemos, Pedro A.; Tzvi, Margalit Ben; Wijns, William; Unger, Felix; Beyar, Rafael; Serruys, Patrick W.

doi:10.1016/j.amjcard.2004.10.007

Cited by 118 publications

(86 citation statements)

References 18 publications

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“…In our study, ob- In our study, chest tube drainage among the two groups was similar and no significant difference in the bleeding reexploration was observed. Similar finding have been described previously [11] [23] [46]. Although not proven, it revealed that obesity was protective for postoperative hemorrhage.…”

Section: Discussionsupporting

confidence: 79%

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

Aithoussa¹,

Atmani²,

Seghrouchni³

et al. 2017

WJCS

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Background: The aim of this study was to quantify the effect of obesity on early results after coronary artery bypass grafting (CABG). Methods: A retrospective cohort study of patients underwent isolated CABG from January 2000 through December 2012 was conducted. 586 patients were classified into two groups: Obese (n = 100) BMI ≥ 30 kg/m 2 and non-obese (n = 486) BMI ≤ 30kg/m 2 . Results: The obese patients included more women (p < 0.01), hypertensives (p = 0.01) and dyslipidemics (p = 0001). The CPB, aortic champ times and number of bypass graft were similar between the groups (p = 0.35, p = 0.51 and p = 0.59 respectively). Also the composite of in-hospital mortality and postoperative complication didn't differ between the groups. The incidence of perioperative myocardial infarction, and need for inotropic drugs or IABP were significantly less in obese patients (p = 0.028, p = 0.031 and p < 0.01 respectively). Conclusions: The current study showed that obesity is not a risk factor of adverse events after CABG and continuous to give another aspect of the "obesity paradox".

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Section: Discussionsupporting

confidence: 79%

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

Aithoussa¹,

Atmani²,

Seghrouchni³

et al. 2017

WJCS

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“…Pela facilidade de sua identificação, a pes- [1][2][3][4][5][6][7][8] . Mundialmente, forte ênfase tem sido dada aos efeitos deletérios da obesidade [1][2][3][4][5][6][7][8][9] , cuja freqüência tem aumentando progressivamente em países ocidentais. No entanto, pouca informação científica está atualmente disponível sobre pacientes com muito baixo peso ponderal e o impacto dessa característica sobre o prognóstico de indivíduos com ou sem doença coronariana.…”

Section: Introductionunclassified

Muito baixo peso ponderal em pacientes tratados com angioplastia coronária: impacto na mortalidade precoce e tardia

Lemos¹,

Ribeiro²,

Kajita³

et al. 2008

Rev. Bras. Cardiol. Invasiva

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RESUMOFundamentos: Pacientes de muito baixo peso tratados com intervenção coronária percutânea têm maior risco de complicações durante a internação. Até o momento, não existem estudos para avaliar o efeito a longo prazo do baixo peso após angioplastia coronária na população brasileira. Método: Um total de 3.687 pacientes foi separado em dois grupos, de acordo com o índice de massa corporal (IMC), calculado como peso (em quilogramas) dividido pela altura (em metros) ao quadrado: grupo baixo peso (IMC ≤ 20 kg/m²; 125 pacientes) e grupo não-baixo peso (IMC > 20 kg/m², 3.562 pacientes). A mortalidade intrahospitalar foi avaliada prospectivamente durante a internação inicial. Após a alta, a ocorrência de óbito foi acessada por meio da revisão dos registros hospitalares e contato telefônico. Resultados: Pacientes com IMC ≤ 20 kg/m² apresentavam peso, altura e IMC médios de 49,4 ± 7,1 kg, 1,62 ± 0,10 m, e 18,7 ± 1,1 kg/m², respectivamente. O peso, a altura e o IMC de pacientes com IMC > 20 kg/m² foram de 74,4 ± 13,8 kg, 1,64 ± 0,09 m, e 27,3 ± 4,3 kg/m², respectivamente (p < 0,01 para todas as características). Pacientes do grupo baixo peso apresentaram mortalidade significativamente maior que pacientes com IMC > 20 kg/m² após 2,5 anos da angioplastia (19,4% vs. 6,9%, respectivamente; hazard ratio [HR]: 2,51, intervalo de confiança de 95% [IC 95%]: 1,61-3,91; p < 0,01). Após o ajuste multivariado para a presença de outros fatores de risco, a presença de IMC ≤ 20 kg/m² persistiu como fator independente associado a aumento da mortalidade (HR: 2,04; IC 95%: 1,28-3,25; p < 0,01). Conclusões: O muito baixo peso ponderal, indicado pelo IMC ≤ 20 kg/m², é um fator de risco independente para a ocorrência de óbito precoce e tardio nos primeiros 2,5 anos após intervenção coronária percutânea. Pela facilidade de sua identificação, a pes- SUMMARY Very Low Ponderal Weight in Patients Treated with Coronary Angioplasty: Impact on Early and Late MortalityBackground: Patients with very low weight treated with percutaneous coronary intervention have a greater risk of complications during hospitalization. So far, there have been no studies to evaluate the long-term effect of low weight after coronary angioplasty in the Brazilian population. Methods: A total of 3,687 patients were divided into two groups according to their body mass index (BMI), calculated by dividing the weight in kilograms by the height in metres squared: low-weight group (BMI < 20 kg/m²; 125 patients), and non-low-weight group (BMI > 20 kg/m²; 3,562 patients). The in-hospital mortality was evaluated prospectively during first admission. After discharge, death occurrence was assessed by reviewing hospital records and through telephone contact. Results: Patients with BMI ≤ 20 kg/m² presented weight, height, and BMI averages of 49.4 ± 7.1 kg, 1.62 ± 0.10 m, and 18.7 ± 1.1 kg/m², respectively. The weight, height and BMI of patients with BMI > 20 kg/m² was 74.4 ± 13.8 kg, 1.64 ± 0.09 m, and 27.3 ± 4.3 kg/m², respectively (p < 0.01 for all characteristics). Patients from the ...

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“…Overweight (BMI between 25 and 30 kg/m 2 ) and obese patients (BMI >30 kg/m 2 ) who participated in the ARTS study and underwent CABG, during the mean follow-up of three years, presented a lower need of a new revascularization procedure and lower incidence of major cardiac or cerebrovascular events (death, stroke, transient ischemic attack, sustained neurological deficit and nonfatal acute myocardial infarction) when compared with non-obese patients (BMI <25kg/m 2 ) 17 .…”

Section: Potential Conflict Of Interestmentioning

confidence: 99%