title: Low Body Mass Index, Serum Creatinine, and Cause of Death in Patients Undergoing Percutaneous Coronary Intervention.
abstract: Low body mass index (BMI) and serum creatinine are surrogate markers of frailty and sarcopenia. Their relationship with cause-specific mortality in elderly patients undergoing percutaneous coronary intervention is not well studied.
  
  
  
  We determined long-term cardiovascular and noncardiovascular mortality in 9394 consecutive patients aged ≥65 years who underwent percutaneous coronary intervention from 2000 to 2011. BMI and serum creatinine were divided into 4 categories. During a median follow-up of 4.2 years (interquartile range 1.8-7.3 years), 3243 patients (33.4%) died. In the multivariable model, compared with patients with normal BMI, patients with low BMI had significantly increased all-cause mortality (hazard ratio [HR] 1.4, 95% CI 1.1-1.7), which was related to both cardiovascular causes (HR 1.4, 95% CI 1.0-1.8) and noncardiovascular causes (HR 1.4, 95% CI 1.06-1.9). Compared with normal BMI, significant reduction was noted in patients who were overweight and obese in terms of cardiovascular mortality (overweight: HR 0.77, 95% CI 0.67-0.88; obese: HR 0.80, 95% CI 0.70-0.93) and noncardiovascular mortality (overweight: HR 0.85, 95% CI 0.74-0.97; obese: HR 0.82, 95% CI 0.72-0.95). In a multivariable model, in patients with normal BMI, low creatinine (≤0.70 mg/dL) was significantly associated with increased all-cause mortality (HR 1.8, 95% CI 1.3-2.5) and cardiovascular mortality (HR 2.3, 95% CI 1.4-3.8) compared with patients with normal creatinine (0.71-1.0 mg/dL); however, this was not observed in other BMI categories.
  
  
  
  We identified a new subgroup of patients with low serum creatinine and normal BMI that was associated with increased all-cause mortality and cardiovascular mortality in elderly patients undergoing percutaneous coronary intervention. Low BMI was associated with increased cardiovascular and noncardiovascular mortality. Nutritional support, resistance training, and weight-gain strategies may have potential roles for these patients undergoing percutaneous coronary intervention.
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Kashish
authors: K
authors: Goel
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Rajiv
authors: R
authors: Gulati
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Guy S
authors: GS
authors: Reeder
authors: Division of Biostatistics, Mayo Clinic, Rochester, MN.
authors: Ryan J
authors: RJ
authors: Lennon
authors: Division of Biostatistics, Mayo Clinic, Rochester, MN.
authors: Bradley R
authors: BR
authors: Lewis
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Atta
authors: A
authors: Behfar
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Gurpreet S
authors: GS
authors: Sandhu
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Charanjit S
authors: CS
authors: Rihal
authors: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN singh.mandeep@mayo.edu.
authors: Mandeep
authors: M
authors: Singh
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D002423:Cause of Death; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality* / Q000601:surgery; D003404:Creatinine / Q000378:metabolism*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly; D006333:Heart Failure / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality; D009765:Obesity / Q000097:blood / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine
keywords: body mass index; cause of death; creatinine; frailty; percutaneous coronary intervention