Impact of body mass index on the outcomes following transcatheter aortic valve implantation

Abramowitz, Yigal; Chakravarty, Tarun; Jilaihawi, Hasan; Cox, Justin; Sharma, Rahul; Mangat, Geeteshwar; Nakamura, Mamoo; Cheng, Wen; Makkar, Raj

doi:10.1002/ccd.26394

Cited by 24 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, these data may support the presence of the suggested obesity paradox in patients undergoing TAVI [3,6,11,12]. However, some other studies presented contradictory results, implying no influence of BMI on the prognosis after TAVI [13,14,18]. Despite the similar median value of BMI, overweight/obese groups were represented by a lower percentage of the whole population as compared with our study [13,14,18].…”

Section: Discussionsupporting

confidence: 80%

“…However, some other studies presented contradictory results, implying no influence of BMI on the prognosis after TAVI [13,14,18]. Despite the similar median value of BMI, overweight/obese groups were represented by a lower percentage of the whole population as compared with our study [13,14,18]. Lower periprocedural risk and rate of comorbidities in overweight/obese patients were not connected with differences in survival among BMI categories [13,14,18].…”

Section: Discussioncontrasting

confidence: 69%

“…Despite the similar median value of BMI, overweight/obese groups were represented by a lower percentage of the whole population as compared with our study [13,14,18]. Lower periprocedural risk and rate of comorbidities in overweight/obese patients were not connected with differences in survival among BMI categories [13,14,18]. Furthermore, higher mortality was observed in underweight but not in overweight/obese patients as compared to the normal BMI group [18].…”

Section: Discussioncontrasting

confidence: 60%

“…Intuitively, obesity might lead to higher prevalence of access-site and bleeding complications as well as blood transfusion, but this association was not established in our study. Most of the studies confirmed no differences in AKI and bleeding or vascular complication incidence between BMI categories [3,14,20,23]. A trend towards worse renal function and more periprocedural complications in obese patients was reported by De Palma et al [22]; however, the percentage of obese patients in their study was relatively small.…”

Section: Discussionmentioning

confidence: 72%

“…This discrepancy was also reported in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) [3,[6][7][8][9][10][11][12]. However, some studies reported no effect of body mass index (BMI) on outcomes in patients undergoing TAVI [13,14]. The validated mechanisms of this obesity paradox are elusive.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?

Tokarek¹,

Dziewierz²,

Sorysz³

et al. 2019

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c tBackground: Conflicting results have been presented regarding the influence of body mass index (BMI) on outcomes among patients undergoing transcatheter aortic valve implantation (TAVI). Aims:To investigate the impact of BMI on clinical outcomes after TAVI.Methods: A total of 148 consecutive patients were categorised using baseline BMI according to the World Health Organization criteria. Baseline patient characteristics, frailty, and procedural and clinical outcomes including 30-day and 12-month all-cause mortality were compared between the BMI categories. Patients were followed up for a median of 460.0 (182.0-1042.0) days. Results:Obesity was diagnosed in 37 (25.2%) patients, 73 (49.7%) patients were overweight, and 37 (25.2%) had normal weight. Prevalence of lower frailty as assessed by five-metre walk test was confirmed in obese patients as compared to other groups. A trend towards a lower rate of in-hospital bleeding complications (18 [48.6%] vs. 21 [28.8%] vs. 9 [24.3%] in normal-weight, overweight, and obese patients, respectively; p = 0.06) and less frequent blood transfusions (18 [48.6%] vs. 17 [23.3%) vs. 8 [21.6%]; p = 0.016) was observed in overweight and obese groups. The rate of grade 3 acute kidney injury was lowest in the overweight group (4 [10.8%] vs. 1 [1.4%] vs. 3 [8.1%]; p = 0.05). There was no difference between the groups in terms of 30-day all-cause mortality (p = 0.15). However, 12-month all-cause mortality was lowest in obese patients (12 [32.4%] vs. 10 [13.7%] vs. 2 [5.4%]; p = 0.004). Increase in BMI was independently associated with lower all-cause mortality (hazard ratio [95% confidence interval] per 1 kg/m 2 increase: 0.91 [0.845-0.98]; p = 0.018). Conclusions:Increased BMI was independently associated with survival benefit after TAVI.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 69%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?

Tokarek¹,

Dziewierz²,

Sorysz³

et al. 2019

Kardiol Pol

View full text Add to dashboard Cite

show abstract

Assessment of transabdominal fat volumes as a predictor of prognosis in patients undergoing transcatheter aortic valve replacement

Guler,

Genc,

Yildirim

et al. 2024

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Effect of body mass index on clinical outcome and all-cause mortality in patients undergoing transcatheter aortic valve implantation

et al. 2017

View full text Add to dashboard Cite

ObjectivesTo assess the effect of body mass index (BMI) on outcome among patients with severe aortic stenosis (AS) admitted for transcatheter aortic valve implantation (TAVI).BackgroundBeing overweight or obese is associated with improved outcome following certain medical treatments, suggesting the existence of a BMI paradox. However, the relationship between BMI and mortality after TAVI remains controversial.MethodsPatients were classified according to World Health Organisation criteria such as normal weight, overweight, or obesity according to their BMI (18.5 to 24.9 kg/m2, 25.0 to 29.9 kg/m2, and ≥30.0 kg/m2, respectively).ResultsA total of 549 consecutive patients (age: 80.2 ± 7.5 years; logistic European system for cardiac operative risk evaluation [EuroSCORE]: 17.3 ± 9.9%) who underwent TAVI for AS were included. Of these patients, 43% (n = 237) had normal weight, 36% (n = 200) were overweight, and 20% (n = 112) were obese. There were no differences in peri-operative bleeding or vascular complication rates between the groups. All-cause mortality after 30 days, and 1 year, were higher in normal weight patients compared with overweight and obese patients (7% vs. 5 and 4%, p = 0.383, and 19% vs. 9 and 10%, p = 0.006, respectively). After adjustment for several confounding factors, overweight was associated with a decreased 30-day and 1‑year all-cause mortality outcome (hazard ratio [HR] 0.69; 95% confidence interval [CI] 0.47–0.99, and HR 0.65; 95% CI 0.45–0.94, respectively).ConclusionsDespite the well-documented adverse effects of increased body weight on health, being overweight is associated with improved survival following TAVI when compared with normal weight.

show abstract

Impact of body mass index on the outcomes following transcatheter aortic valve implantation

Cited by 24 publications

References 33 publications

The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?

The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?

Assessment of transabdominal fat volumes as a predictor of prognosis in patients undergoing transcatheter aortic valve replacement

Effect of body mass index on clinical outcome and all-cause mortality in patients undergoing transcatheter aortic valve implantation

Contact Info

Product

Resources

About