title: Effect of obesity on repeat revascularization in patients undergoing percutaneous coronary intervention with drug-eluting stents.
abstract: Obesity is a major risk factor for developing coronary artery disease. The impact of obesity on prognosis among those with established coronary disease is less clear. The objective of this study was to evaluate the effect of obesity on repeat revascularization in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). We examined 6,083 patients who were divided into three groups according to BMI: normal (BMI 18.5-24.9 kg/m(2), n = 1,592); overweight (BMI 25-29.9 kg/m(2), n = 3,026) and obese (BMI >30 kg/m(2), n = 1,465). The follow-up focused on clinical-driven repeat revascularization, including target lesion revascularization (TLR) and nonTLR. Median follow-up was 26 months (interquartile range 20-32). There was no significant difference in the incidence of TLR among normal, overweight, and obese patients (6.3% vs. 6.1% vs. 7.1%; P = 0.423). In contrast, the incidence of nonTLR was significantly higher in obese patients compared with normal and overweight (8.4% vs. 6.0% vs. 5.8%, P = 0.003). Multivariate analysis showed that obesity was an independent predictor of nonTLR during follow-up (hazard ratio = 1.39; 95% confidence interval = 1.06-1.83; P = 0.019), along with diabetes and hypercholesterolemia. Concomitant use of statins was independently associated with decreased risk of nonTLR (hazard ratio = 0.75; 95% confidence interval = 0.62-0.92; P = 0.005). In conclusion, among patients undergoing PCI with DES, obesity was not associated with TLR, but was associated with a higher risk of nonTLR.
authors: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors: Zhi Jian
authors: ZJ
authors: Wang
authors: Yu Jie
authors: YJ
authors: Zhou
authors: Ying Xin
authors: YX
authors: Zhao
authors: Yu Yang
authors: YY
authors: Liu
authors: Dong Mei
authors: DM
authors: Shi
authors: Xiao Li
authors: XL
authors: Liu
authors: Miao
authors: M
authors: Yu
authors: Fei
authors: F
authors: Gao
mesh_terms: D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D023903:Coronary Restenosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D018450:Disease Progression; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome