Impact of changes in body mass index after percutaneous coronary intervention on long-term outcomes in patients with coronary artery disease

Abstract

Little is known about the impact of changes in body mass index (BMI) after the percutaneous coronary intervention (PCI) on long-term outcomes in patients with coronary artery disease (CAD). Therefore, this study aimed to clarify this issue. We investigated data on CAD obtained from the SHINANO Registry, a prospective, observational, multicenter cohort study, from 2012 to 2013 in Nagano, Japan. One year after PCI, the enrolled patients were divided into the following three groups based on changes in BMI by tertiles: reduced, maintained, and elevated BMI. The associations among the groups and the 4-year outcomes [major adverse cardiac events (MACEs), all-cause death, Q-wave myocardial infarction, and stroke] were examined. Five hundred seventy-two patients were divided into the reduced, maintained, and elevated BMI groups. Over the 4-year follow-up period, the cumulative incidence of MACEs was 10.5% (60 cases). In the Kaplan–Meier analysis, the incidence rates of MACE were significantly higher in the reduced BMI group than in the maintained and elevated BMI groups [17.7% versus (vs.) 7.3% vs. 9.0%, p = 0.004]. Multivariable cox regression analysis showed that the reduced group showed increased risks of MACEs (hazard ratio 2.15; 95% confidence interval 1.29–3.57; p = 0.003). The long-term clinical outcomes of patients with CAD who underwent PCI were affected by the reduction in BMI after PCI. Furthermore, the elevation of BMI after PCI was not a poor prognostic factor.

Relationship of Body Fat and Left ventricular hypertrophy with the Risk of All-cause Death in Patients with Coronary Artery Disease

“…In a prospective multicenter study, patients who had undergone percutaneous coronary intervention were divided into three groups according to the changes of BMI. During a follow up of 4 years, patients with reduced BMI have a signi cantly higher risk of incident major adverse cardiac events than those with maintained or increased BMI, even after adjusting for confounders [14]. BMI uctuation and decrease were also associated with cardiovascular death in patients with myocardial infarction and left ventricular dysfunction or heart failure [15].…”

Differential associations between body mass index and outcome in different age groups in patients with myocardial infarction

“…Previous reports have shown that purposeful weight loss in such patients may not be beneficial and may even be harmful. 4 , 10 , 29 , 30 We, and others previously, believe that there is no clear evidence that weight loss is beneficial after MI, especially in patients aged >75 years. 4 , 6 , 10 , 16 According to our findings, moderate weight loss should be recommended only for elderly people with obesity grade III.…”

“…Our results should be considered hypothesis-generating for future research, especially because we had no data on cardiorespiratory fitness and could not track data on long-term changes in BMI. 29 …”

A obesidade e sua relação com o infarto agudo do miocárdio: uma revisão de literatura

“…A obesidade está diretamente associada ao aumento da mortalidade por doenças crônicas, dentre elas as doenças cardiovasculares, tendo grande importância como fator de risco para Doença Arterial Coronariana (DAC) . A elevação do IMC (>30 kg/m²) se mostrou como importante fator de risco para a ocorrência de IAM tendo como excessão indivíduos com obesidade metabólicamente saudável, que apresentaram resultados semelhantes a indivíduos com o IMC dentro da média considerada normal, porém esses casos foram raros visto que a maioria dos indivíduos obesos apresentaram distúrbios Em contrapartida, em doentes com doenças crônicas ou submetidos a intervenções cirúrgicas, tem -se percebido que a obesidade e o excesso de peso vêm sendo associados a menor taxa de Ainda, a mudança do peso corporal também f oi associada ao aumento da incidência de DCV, tanto a perda de peso quanto o aumento do peso f oram apontadas como f atores de mau p rognóstico nos casos de pacientes com DCV e Intervenção Coronária Percutânea, sendo a manutenção do peso corporal melhor do que o emagrecimento nesses casos, independente de obesidade e sobrepeso (LEE YB, et al, 2021;YUI H, et al, 2020).…”