title: Meta-Analysis of Effect of Body Mass Index on Outcomes After Transcatheter Aortic Valve Implantation.
abstract: Controversial data exist regarding the impact of body mass index (BMI) on TAVI outcomes. Thirteen TAVI studies were included and analyzed for the incidence of procedural complications, 30-day, and long-term all-cause mortality. Three comparisons were executed: (1) underweight versus normal weight, (2) overweight versus normal weight, and (3) obese versus normal weight patients. Underweight patients (BMI <20 kg/m2) had similar 30-day all-cause mortality compared with the normal, although they displayed a significant worse survival at long-term follow-up (hazard ratio 1.68, 95% confidence interval (CI) 1.09 to 2.59, p = 0.02). Underweight patients showed a higher incidence of major and life-threatening bleedings (2,566 patients, odds ratio 1.64, 95% CI 1.10 to 2.45, p = 0.02) and of major vascular complications (2,566 patients, odds ratio 1.86, 95% CI 1.16 to 2.98, p = 0.01), compared with normal weight patients. Overweight patients (BMI ≥25 and <30 kg/m2) display similar 30-day and long-term all-cause mortality, as well as similar procedural complication rate compared with normal weight patients. Obese patients (BMI >30 kg/m2) had similar 30-day all-cause mortality rates compared with the normal weight category, whereas they displayed a significant better survival at long-term (hazard ratio 0.79, 95% CI 0.67 to 0.93, p = 0.004). Procedural complications did not differ between obese and normal body weight patients. In conclusion, a low BMI is linked to a significantly worse prognosis after TAVI. Therefore, BMI represents an important and handily tool that might be used in the risk prediction of patients to be addressed for TAVI.
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; Division of Cardiology, Baylor University Medical Center, Dallas, Texas.
authors.forename: Anna
authors.initials: A
authors.lastname: Sannino
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Gabriele Giacomo
authors.initials: GG
authors.lastname: Schiattarella
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Evelina
authors.initials: E
authors.lastname: Toscano
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gargiulo
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giugliano
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Galderisi
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Maria-Angela
authors.initials: MA
authors.lastname: Losi
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Stabile
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Plinio
authors.initials: P
authors.lastname: Cirillo
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imbriaco
authors.affiliation: Division of Cardiology, Baylor University Medical Center, Dallas, Texas.
authors.forename: Paul Artur
authors.initials: PA
authors.lastname: Grayburn
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. Electronic address: espogiov@unina.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D015992:Body Mass Index; D006801:Humans; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome