Obesity paradox in a cohort of 4880 consecutive patients undergoing percutaneous coronary intervention.
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.
Hastie
Claire E
CE
British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Padmanabhan
Sandosh
S
Slack
Rachel
R
Pell
Alastair C H
AC
Oldroyd
Keith G
KG
Flapan
Andrew D
AD
Jennings
Kevin P
KP
Irving
John
J
Eteiba
Hany
H
Dominiczak
Anna F
AF
Pell
Jill P
JP
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