title: Relationship of body mass index with total mortality, cardiovascular mortality, and myocardial infarction after coronary revascularization: evidence from a meta-analysis.
abstract: OBJECTIVE
  To investigate the relationship of body mass index (BMI) with total mortality, cardiovascular (CV) mortality, and myocardial infarction (MI) after coronary revascularization procedures (coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]).
  
  
  METHODS
  Systematic search of studies was conducted using PubMed, CINAHL, Cochran CENTRAL, Scopus, and the Web of Science databases. We identified studies reporting the rate of MI, CV mortality, and total mortality among coronary artery disease patients' postcoronary revascularization procedures in various BMI categories: less than 20 (underweight), 20-24.9 (normal reference), 25-29.9 (overweight), 30-34.9 (obese), and 35 or more (severely obese). Event rates were compared using a random effects model assuming interstudy heterogeneity.
  
  
  RESULTS
  A total of 36 studies (12 CABG; 26 PCI) were selected for final analyses. The risk of total mortality (relative risk [RR], 2.59; 95% CI, 2.09-3.21), CV mortality (RR, 2.67; 95% CI, 1.63-4.39), and MI (RR, 1.79; 95% CI, 1.28-2.50) was highest among patients with low BMI at the end of a mean follow-up period of 1.7 years. The risk of CV mortality was lowest among overweight patients (RR, 0.81; 95% CI, 0.68-0.95). Increasing degree of adiposity as assessed by BMI had a neutral effect on the risk of MI for overweight (RR, 0.92; 95% CI, 0.84-1.01), obese (RR, 0.99; 95% CI, 0.85-1.15), and severely obese (RR, 0.93; 95% CI, 0.78-1.11) patients.
  
  
  CONCLUSIONS
  After coronary artery disease revascularization procedures (PCI and CABG), the risk of total mortality, CV mortality, and MI was highest among underweight patients as defined by low BMI and CV mortality was lowest among overweight patients.
authors.affiliation: Department of Medicine, Maimonides Medical Center, Brooklyn, NY. Electronic address: abhisheksharma4mamc@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Division of Cardiology, University of Kansas Medical Center, Kansas City.
authors.forename: Ajay
authors.initials: A
authors.lastname: Vallakati
authors.affiliation: Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Medical Center, New York, NY.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Einstein
authors.affiliation: Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans, LA; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Armin
authors.initials: A
authors.lastname: Arbab-Zadeh
authors.affiliation: Division of Cardiology, Mayo College of Medicine, Rochester, MN.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.affiliation: Division of Cardiology, Texas Tech University, El Paso.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: Department of Medicine, Maimonides Medical Center, Brooklyn, NY.
authors.forename: Edgar
authors.initials: E
authors.lastname: Lichstein
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality / Q000601:surgery; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery; D016206:Databases, Bibliographic; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000601:surgery; D009204:Myocardial Revascularization / Q000401:mortality*; D050177:Overweight / Q000401:mortality*; D012307:Risk Factors; D013851:Thinness / Q000401:mortality*