title: Effect of body mass index <20 kg/m(2) on events in patients who underwent transcatheter aortic valve replacement.
abstract: The Valve Academic Research Consortium-2 has defined body mass index (BMI) <20 as indicative of frailty, which may be one of the co-morbidities not captured by traditional risk factors after transcatheter aortic valve replacement (TAVR). This study aimed to assess the impact of low BMI on clinical outcomes after TAVR. A total of 777 consecutive patients scheduled for TAVR were classified into 3 groups as BMI <20 (n = 56), 20 to 24.9 (n = 322), and ≥25 (n = 399). Procedural complications and clinical outcomes were compared among the 3 groups. They were also analyzed according to propensity-matching model A (BMI <20 [n = 50] vs ≥20 [n = 50]), model B (BMI <20 [n = 50] vs 20 to 24.9 [n = 50]), and model C (BMI <20 [n = 47] vs ≥25 [n = 47]). The differences in baseline characteristics among the 3 groups were adequately adjusted in 3 matched models. Valve Academic Research Consortium-2-defined end points and other complications were similar among the 3 groups in each model. Kaplan-Meier curves indicated no significant differences in cumulative 30-day survival (BMI <20 [91.0%] vs 20 to 24.9 [86.3%], p = 0.33; BMI <20 [91.0%] vs ≥25 [91.4%], p = 0.91, respectively) and 1-year survival (BMI <20 [74.3%] vs 20 to 24.9 [71.8%], p = 0.71; BMI <20 [74.3%] vs ≥25 [77.0%], p = 0.71; respectively). These survival rates were also similar in each of the 3 matched models. In conclusion, BMI <20 was not associated with increased early or midterm mortality. BMI <20 alone may not constitute an additional co-morbidity factor in patients who underwent TAVR.
authors.affiliation: Department of Interventional Cardiology, Assistance publique - Hôpitaux de Paris, Henri Mondor University Hospital, Créteil, France. Electronic address: masa-nori@nms.ac.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Institut Cardiovasculaire Paris Sud, Générale de Santé, Massy, France.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashida
authors.affiliation: Institut Cardiovasculaire Paris Sud, Générale de Santé, Massy, France.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Interventional Cardiology, Assistance publique - Hôpitaux de Paris, Henri Mondor University Hospital, Créteil, France.
authors.forename: Gauthier
authors.initials: G
authors.lastname: Mouillet
authors.affiliation: Institut Cardiovasculaire Paris Sud, Générale de Santé, Massy, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hovasse
authors.affiliation: Institut Cardiovasculaire Paris Sud, Générale de Santé, Massy, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.affiliation: Department of Interventional Cardiology, Assistance publique - Hôpitaux de Paris, Henri Mondor University Hospital, Créteil, France.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Oguri
authors.affiliation: Department of Medical Cardiology, AP-HP, Henri Mondor University Hospital, Créteil, France; Faculty of Medicine, Université Paris Est, Créteil, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Dubois-Randé
authors.affiliation: Institut Cardiovasculaire Paris Sud, Générale de Santé, Massy, France.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Morice
authors.affiliation: Institut Cardiovasculaire Paris Sud, Générale de Santé, Massy, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.affiliation: Department of Interventional Cardiology, Assistance publique - Hôpitaux de Paris, Henri Mondor University Hospital, Créteil, France; Faculty of Medicine, Université Paris Est, Créteil, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome