title: [Impact of overweight on clinical outcomes in patients undergoing coronary revascularization].
abstract: OBJECTIVE
  To determine the impact of BMI on clinical outcome in patients with heart failure underwent coronary revascularization.
  
  
  METHODS
  The DESIRE-plus (Drug-Eluting Stent Impact on Revascularization-plus) was a single-center registry of coronary revascularization in our institution between July 1, 2004 and September 30, 2005. We analyzed heart failure patients with the complete data of body mass index (BMI) data from the DESIRE-plus trial and grouped them by BMI (normal BMI group, BMI < 24; overweight group, BMI 24-27.9; obesity group, BMI > or = 28). Total mortality, cardiac mortality and MACCE including death, neo-myocardial infarction, stroke, re-revascularization were recorded. We evaluated risk estimates for three bodyweight groups.
  
  
  RESULTS
  1010 patients were included in the study (295 in normal BMI group; 495 in overweight group and 220 obesity group). Median follow-up was 542 days. Overweight and obese patients were younger (59.3 +/- 10.14 years, 58.6 +/- 10.30 years vs 62.6 +/- 9.93 years, P < 0.01) and had a significantly higher incidence of hypertension (61.2, 66.8% vs 52.5%, P = 0.017), stable angina pectoris (21.2%, 23.7% vs 17.0%, P = 0.05) and higher triglyceride [(1.90 +/- 1.05) mmol/L, (2.10 +/- 1.12) mmol/L vs (1.48 +/- 0.92) mmol/L, P < 0.01)], fasting blood glucose level [(6.07 +/- 2.09) mmol/L, (5.96 +/- 1.53) mmol/L vs (5.67 +/- 1.92) mmol/L, P = 0.021), blood creatinine (84.9 +/- 21.7) micromol/L, (90.2 +/- 30.9) micromol/L vs (82.2 +/- 25.8) micromol/L, P = 0.002] compared with normal BMI patients. Multivariate Cox regression model showed obese patients had an decreased hazard risk (HR) for total mortality (0.285, 95%CI 0.104 - 0.777) and MACCE (0.596, 95%CI 0.401 - 0.885) compared with those for patients with normal BMI, overweight patients had no increased risk for total mortality (HR 0.769, 95%CI 0.442 - 1.338) and MACCE (0.998, 95%CI 0.754 - 1.322), there was hardly any significantly difference in cardiac mortality between three groups (P = 0.223).
  
  
  CONCLUSIONS
  There were more risk factors in heart failure patients with coronary heart disease complicated with obesity or overweight, but the prognosis after revascularization of them is at least no worse than the normal weight coronary heart disease patients.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Jun-ping
authors.initials: JP
authors.lastname: Kang
authors.forename: Chang-sheng
authors.initials: CS
authors.lastname: Ma
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lü
authors.forename: Shao-ping
authors.initials: SP
authors.lastname: Nie
authors.forename: Xin-min
authors.initials: XM
authors.lastname: Liu
authors.forename: Xiao-hui
authors.initials: XH
authors.lastname: Liu
authors.forename: Xin
authors.initials: X
authors.lastname: DU
authors.forename: Rong
authors.initials: R
authors.lastname: Hu
authors.forename: Jian-zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.forename: Shu-zheng
authors.initials: SZ
authors.lastname: Lü
authors.forename: Cheng-xiong
authors.initials: CX
authors.lastname: Gu
authors.forename: Fang-jiong
authors.initials: FJ
authors.lastname: Huang
authors.forename: Xue-si
authors.initials: XS
authors.lastname: Wu
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015992:Body Mass Index; D054855:Drug-Eluting Stents; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors