Author + information
- Perwaiz M. Meraj,
- Rajkumar Doshi,
- Bhavitha George,
- Lakhbir Kaur,
- Abhishek Vadher and
- Amitkumar Patel
It has been previously described that obese patients have better outcomes post coronary intervention (PCI) as compared to non-obese patients given their younger age and fewer co-morbidities, however this is not apparent in clinical practice. This study sought to evaluate the in-hospital outcomes among patients with a BMI > 30 and those < 30.
Between Jan 2011 and Sept 2015 22,454 patients underwent PCI; 6,932 with BMI > 30, and 15,522 with BMI < 30. Outcomes included in-hospital mortality, myocardial infarction (MI), stroke, renal failure requiring dialysis, and bleeding complications requiring transfusion. Multivariable analysis was used to assess the independent associations.
Among the entire cohort, 16,098 (71.69%) were male and 6,356 (28.30%) female. Baseline differences existed, notably in heparin and radial access use however, after multivariable adjustment, obesity was independently associated with increased transfusion requiring bleeding and MI, with a trend to increased mortality.
Although much data has been published reporting the improved outcomes of obese patients post PCI, defining the obesity paradox, this large study demonstrates in a real-world cohort of patients treated with current therapies to reduced bleeding complications and improve outcomes, patients with a BMI > 30 are at higher risk of MI and bleeding requiring transfusions.