title: Obesity paradox in a cohort of 4880 consecutive patients undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  We sought to investigate the impact of body mass index (BMI) on long-term all-cause mortality in patients following first-time elective percutaneous coronary intervention (PCI).
  
  
  RESULTS
  We used the Scottish Coronary Revascularisation Register to undertake a cohort study of all patients undergoing elective PCI in Scotland between April 1997 and March 2006 inclusive. We excluded patients who had previously undergone revascularization. There were 219 deaths within 5 years of 4880 procedures. Compared with normal weight individuals, those with a BMI > or =27.5 and <30 were at reduced risk of dying (HR 0.59, 95% CI 0.39-0.90, 95%, P = 0.014). There was no attenuation of the association after adjustment for potential confounders, including age, hypertension, diabetes, and left ventricular function (adjusted HR 0.59, 95% CI 0.39-0.90, P = 0.015), and there were no statistically significant interactions. The results were unaltered by restricting the analysis to events beyond 30 days of follow-up.
  
  
  CONCLUSIONS
  Among patients undergoing percutaneous intervention for coronary artery disease, increased BMI was associated with improved 5 year survival. Among those with established coronary disease, the adverse effects of excess adipose tissue may be offset by beneficial vasoactive properties.
authors.affiliation: British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Hastie
authors.forename: Sandosh
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: Rachel
authors.initials: R
authors.lastname: Slack
authors.forename: Alastair C H
authors.initials: AC
authors.lastname: Pell
authors.forename: Keith G
authors.initials: KG
authors.lastname: Oldroyd
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Flapan
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Jennings
authors.forename: John
authors.initials: J
authors.lastname: Irving
authors.forename: Hany
authors.initials: H
authors.lastname: Eteiba
authors.forename: Anna F
authors.initials: AF
authors.lastname: Dominiczak
authors.forename: Jill P
authors.initials: JP
authors.lastname: Pell
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology