2012-03-12
The influence of optimal medical treatment on the 'obesity paradox', body mass index and long-term mortality in patients treated with percutaneous coronary intervention: A prospective cohort study
Publication
Publication
BMJ Open , Volume 2 - Issue 1
Objective: To assess whether the obesity paradox persists in the long term and to study the effect of optimal medical treatment on this phenomenon. Design: A retrospective cohort study. Setting: A tertiary care centre in Rotterdam. Participants: From January 2000 to December 2005, 6332 patients undergoing percutaneous coronary intervention for coronary artery disease were categorised into underweight (body mass index (BMI)<18.5), normal (18.5-24.9), overweight (25-29.9) and obese (>30). Primary outcome measure: Mortality. Secondary outcome measures: Cardiac death and non-fatal myocardial infarction. Results: Optimal medical treatment was more common in obese patients as compared with normal weight patients (85% vs 76%; p<0.001). At a mean of 6.1 years, overweight and obese patients had a lower risk of all-cause mortality (HR: 0.75, 95% CI 0.66 to 0.86 and HR: 0.72, 95% CI 0.60 to 0.87, respectively). After adjusting for OMT in the multivariate analysis, BMI did not remain an independent predictor of longterm mortality (HR: 0.90, 95% CI 0.72 to 1.12 and HR: 1.07, 95% CI: 0.80 to 1.43, respectively). Conclusion: BMI is inversely related to long-term mortality in patients treated with percutaneous coronary intervention. Patients with a normal BMI are on suboptimal medical treatment when compared with those with a high BMI. A more optimal medical treatment in the obese group may explain the observed improved outcome in these patients.
Additional Metadata | |
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doi.org/10.1136/bmjopen-2011-000535, hdl.handle.net/1765/68908 | |
BMJ Open | |
Organisation | Department of Cardiology |
Schenkeveld, L., Magro, M., Oemrawsingh, R., Lenzen, M., de Jaegere, P., van Geuns, R. J., … van Domburg, R. (2012). The influence of optimal medical treatment on the 'obesity paradox', body mass index and long-term mortality in patients treated with percutaneous coronary intervention: A prospective cohort study. BMJ Open, 2(1). doi:10.1136/bmjopen-2011-000535 |