Normal BMI patients at greater risk for complications after angioplasty

מתוך medicontext.co.il
NEW YORK (Reuters Health) – Compared with overweight and obese patients who undergo percutaneous coronary intervention (PCI), normal weight and lean patients have a higher risk of in-hospital complications, cardiac death, and 1-year mortality, researchers report in the Journal of the American College of Cardiology for February 20.

Dr. Luis Gruberg and colleagues, from Washington Hospital Center, Washington, DC, collected data on 9633 consecutive men and women who underwent PCI between January 1994 and December 1999.

The researchers divided the patients into three groups based on body mass index (BMI). Patients with a BMI between 18.5 and 24.9 were defined as normal weight, those with a BMI between 25 and 30 were defined as overweight, and those with a BMI greater than 30 were considered obese.

Compared with other patient groups, obese patients had a higher incidence of hypertension, diabetes, hypercholesterolemia, and smoking, and were significantly younger, Dr. Gruberg's team notes.

Although the success rate for PCI was similar between the groups, normal weight patients had a higher incidence of in-hospital complications and cardiac death compared with overweight and obese patients, the researchers found.

One-year mortality was also significantly higher among patients with normal BMI compared with overweight and obese patients. Mortality rates were also considerably higher among women whose BMI was less than 18.5, compared with their male counterparts.

There was no difference between patient groups in the rates of MI or revascularization, the investigators point out. Multivariate analysis showed that the independent predictors of long-term mortality were diabetes, hypertension, age, BMI, and left ventricular ejection fraction, they add.

Dr. Gruberg's group notes that their findings differ from their working hypothesis, which was that overweight and obese patients would fare less well after PCI. "Contrary to our supposition, we found that normal BMI patients (male or female, smokers or nonsmokers) had higher in-hospital and 1-year mortality rates when compared with overweight or obese patients, despite a better baseline clinical profile."

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