Body Mass Index and Repeat Revascularization After Percutaneous Coronary Intervention: A Meta-analysis.
BACKGROUND
The effect of obesity on restenosis in patients who undergo percutaneous coronary intervention (PCI) has not been fully understood. We undertook a meta-analysis for the effects of body mass index (BMI) on repeat revascularization in these patients.


METHODS
A systematic search was conducted for published studies in OVID/MEDLINE, EMBASE, and the Cochrane library databases from 1980 to October, 2014. We identified studies that provided estimates for repeat revascularization on the basis of BMI in patients who underwent PCI. Summary estimates of risk ratios (RRs) were obtained for 5 prespecified BMI groups: underweight, normal weight, overweight, obese, and severely obese.


RESULTS
A total of 13 studies with 49,002 patients were included in the final analyses. In contrast to a J-shaped association for mortality, a linear association was observed across BMI categories for repeat revascularization. Using normal weight as the reference, underweight was associated with a similar risk of repeat revascularization (RR, 0.93; 95% confidence interval [CI], 0.67-1.31), overweight, obesity, and severe obesity were all associated with incrementally greater risk of repeat revascularization (overweight: RR, 1.08; 95% CI, 1.02-1.14; obesity: RR, 1.10; 95% CI, 1.03-1.18; severe obesity: RR, 1.24; 95% CI, 1.04-1.48). The effect of overweight and obesity vs normal weight was consistent across stent types (drug-eluting stent and bare-metal stent) and definitions of repeat revascularization (target lesion revascularization, target vessel revascularization, and all revascularization).


CONCLUSIONS
Our data revealed a linear relationship between BMI categories and repeat revascularization for patients who underwent PCI. The risk was lowest among underweight or normal weight patients, and highest among severely obese patients.
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China.
Zhi Jian
ZJ
Wang
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China.
Fei
F
Gao
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China.
Wan Jun
WJ
Cheng
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China.
Qing
Q
Yang
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China. Electronic address: azzyj12@163.com.
Yu Jie
YJ
Zhou
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015992:Body Mass Index; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011379:Prognosis; D011859:Radiography; D019233:Retreatment / Q000379:methods; D018570:Risk Assessment; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome