Effect of Body Mass Index on Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation
Better outcomes have been reported after percutaneous cardiac intervention in obese patients (“obesity paradox”). However, limited information is available on the effect of the body mass index on the outcomes after transcatheter aortic valve implantation (TAVI). We, therefore, sought to determine th...
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| Veröffentlicht in: | The American journal of cardiology 2013-01, Vol.111 (2), p.231-236 |
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| creator | van der Boon, Robert M.A., MSc Chieffo, Alaide, MD Dumonteil, Nicolas, MD Tchetche, Didier, MD Van Mieghem, Nicolas M., MD Buchanan, Gill L., MBChB Vahdat, Olivier, MD Marcheix, Bertrand, MD, PhD Serruys, Patrick W., MD, PhD Fajadet, Jean, MD Colombo, Antonio, MD, PhD Carrié, Didier, MD, PhD van Domburg, Ron T., PhD de Jaegere, Peter P.T., MD, PhD |
| description | Better outcomes have been reported after percutaneous cardiac intervention in obese patients (“obesity paradox”). However, limited information is available on the effect of the body mass index on the outcomes after transcatheter aortic valve implantation (TAVI). We, therefore, sought to determine the effect of the body mass index on the short- and long-term outcomes in patients who underwent TAVI. The population consisted of 940 patients, of whom 25 (2.7%) were underweight, 384 had a (40.9%) normal weight, 372 (39.6%) were overweight, and 159 (16.9%) were obese. Overall, the obese patients were younger (79.7 ± 6.4 years vs 81.7 ± 7.3 and 80.8 ± 7.0 years, p = 0.008) and had a greater prevalence of preserved left ventricular and renal function. On univariate analysis, obese patients had a greater incidence of minor stroke (1.3% vs 0 and 0.3%, p = 0.03), minor vascular complications (15.7% vs 9.1% and 11.6%, p = 0.028) and acute kidney injury stage I (23.3% vs 10.7% and 16.1%, p |
| doi_str_mv | 10.1016/j.amjcard.2012.09.022 |
| format | Article |
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However, limited information is available on the effect of the body mass index on the outcomes after transcatheter aortic valve implantation (TAVI). We, therefore, sought to determine the effect of the body mass index on the short- and long-term outcomes in patients who underwent TAVI. The population consisted of 940 patients, of whom 25 (2.7%) were underweight, 384 had a (40.9%) normal weight, 372 (39.6%) were overweight, and 159 (16.9%) were obese. Overall, the obese patients were younger (79.7 ± 6.4 years vs 81.7 ± 7.3 and 80.8 ± 7.0 years, p = 0.008) and had a greater prevalence of preserved left ventricular and renal function. On univariate analysis, obese patients had a greater incidence of minor stroke (1.3% vs 0 and 0.3%, p = 0.03), minor vascular complications (15.7% vs 9.1% and 11.6%, p = 0.028) and acute kidney injury stage I (23.3% vs 10.7% and 16.1%, p <0.001). After adjustment, body mass index, as a continuous variable, was associated with a lower risk of mortality at 30 days (odds ratio 0.93, 95% confidence interval 0.86 to 0.98, p = 0.023) and no effect on survival after discharge (hazard ratio 1.01, 95% confidence interval 0.96 to 1.07, p = 0.73). In conclusion, obesity was associated with a greater incidence of minor, but no major, perioperative complications after TAVI. After adjustment, obesity was associated with a lower risk of 30-day mortality and had no adverse effect on mortality after discharge, underscoring the “obesity paradox” in patients undergoing TAVI.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2012.09.022</identifier><identifier>PMID: 23102879</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aortic Valve ; Aortic Valve Stenosis - complications ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - surgery ; Body Mass Index ; Cardiac Catheterization - methods ; Cardiovascular ; Cardiovascular disease ; Drug therapy ; Europe - epidemiology ; Follow-Up Studies ; Heart attacks ; Heart Valve Prosthesis ; Hospital Mortality - trends ; Humans ; Kaplan-Meier Estimate ; Length of Stay ; Mortality ; Obesity ; Obesity - complications ; Obesity - mortality ; Odds Ratio ; Postoperative Period ; Risk Assessment - methods ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>The American journal of cardiology, 2013-01, Vol.111 (2), p.231-236</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c561t-e67232680c028cf6d0f0f9c0567e6e996064ed6568aa2d343f51dee4657d30963</citedby><cites>FETCH-LOGICAL-c561t-e67232680c028cf6d0f0f9c0567e6e996064ed6568aa2d343f51dee4657d30963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S000291491202200X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23102879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Boon, Robert M.A., MSc</creatorcontrib><creatorcontrib>Chieffo, Alaide, MD</creatorcontrib><creatorcontrib>Dumonteil, Nicolas, MD</creatorcontrib><creatorcontrib>Tchetche, Didier, MD</creatorcontrib><creatorcontrib>Van Mieghem, Nicolas M., MD</creatorcontrib><creatorcontrib>Buchanan, Gill L., MBChB</creatorcontrib><creatorcontrib>Vahdat, Olivier, MD</creatorcontrib><creatorcontrib>Marcheix, Bertrand, MD, PhD</creatorcontrib><creatorcontrib>Serruys, Patrick W., MD, PhD</creatorcontrib><creatorcontrib>Fajadet, Jean, MD</creatorcontrib><creatorcontrib>Colombo, Antonio, MD, PhD</creatorcontrib><creatorcontrib>Carrié, Didier, MD, PhD</creatorcontrib><creatorcontrib>van Domburg, Ron T., PhD</creatorcontrib><creatorcontrib>de Jaegere, Peter P.T., MD, PhD</creatorcontrib><creatorcontrib>PRAGMATIC-Plus Researchers</creatorcontrib><title>Effect of Body Mass Index on Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Better outcomes have been reported after percutaneous cardiac intervention in obese patients (“obesity paradox”). However, limited information is available on the effect of the body mass index on the outcomes after transcatheter aortic valve implantation (TAVI). We, therefore, sought to determine the effect of the body mass index on the short- and long-term outcomes in patients who underwent TAVI. The population consisted of 940 patients, of whom 25 (2.7%) were underweight, 384 had a (40.9%) normal weight, 372 (39.6%) were overweight, and 159 (16.9%) were obese. Overall, the obese patients were younger (79.7 ± 6.4 years vs 81.7 ± 7.3 and 80.8 ± 7.0 years, p = 0.008) and had a greater prevalence of preserved left ventricular and renal function. On univariate analysis, obese patients had a greater incidence of minor stroke (1.3% vs 0 and 0.3%, p = 0.03), minor vascular complications (15.7% vs 9.1% and 11.6%, p = 0.028) and acute kidney injury stage I (23.3% vs 10.7% and 16.1%, p <0.001). After adjustment, body mass index, as a continuous variable, was associated with a lower risk of mortality at 30 days (odds ratio 0.93, 95% confidence interval 0.86 to 0.98, p = 0.023) and no effect on survival after discharge (hazard ratio 1.01, 95% confidence interval 0.96 to 1.07, p = 0.73). In conclusion, obesity was associated with a greater incidence of minor, but no major, perioperative complications after TAVI. After adjustment, obesity was associated with a lower risk of 30-day mortality and had no adverse effect on mortality after discharge, underscoring the “obesity paradox” in patients undergoing TAVI.</description><subject>Aortic Valve</subject><subject>Aortic Valve Stenosis - complications</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Body Mass Index</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Drug therapy</subject><subject>Europe - epidemiology</subject><subject>Follow-Up Studies</subject><subject>Heart attacks</subject><subject>Heart Valve Prosthesis</subject><subject>Hospital Mortality - trends</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Length of Stay</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - mortality</subject><subject>Odds Ratio</subject><subject>Postoperative Period</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk-P0zAQxS0EYkvhI4AsceGS4D-JU19AZbXsVirawxbEzTL2mDokcbGTFf32OGoBaS-crJF-bzzz3iD0kpKSEiretqXuW6OjLRmhrCSyJIw9Qgu6amRBJeWP0YIQwgpJK3mBnqXU5pLSWjxFF4xTwjK4QPsr58CMODj8Idgj_qRTwpvBwi8cBny3D3EssB4s3obhe7GD2OPbaTShh4TXboSId1EPyehxD3O1zgJv8Bfd3QPe9IdOD6MefRieoydOdwlenN8l-vzxand5U2xvrzeX621hakHHAkTDOBMrYvKAxglLHHHSkFo0IEBKQUQFVtRipTWzvOKuphagEnVjOZGCL9GbU99DDD8nSKPqfTLQ5UEgTElR1nBWc5kdWqLXD9A2THHI02VKCCJZRVmm6hNlYkgpglOH6Hsdj4oSNUehWnWOQs1RKCJVjiLrXp27T996sH9Vf7zPwPsTANmOew9RJeNhMGB9zJEoG_x_v3j3oIPp_OCN7n7AEdK_bVTKGnU338N8DpRlNSFf-W-ZBq-C</recordid><startdate>20130115</startdate><enddate>20130115</enddate><creator>van der Boon, Robert M.A., MSc</creator><creator>Chieffo, Alaide, MD</creator><creator>Dumonteil, Nicolas, MD</creator><creator>Tchetche, Didier, MD</creator><creator>Van Mieghem, Nicolas M., MD</creator><creator>Buchanan, Gill L., MBChB</creator><creator>Vahdat, Olivier, MD</creator><creator>Marcheix, Bertrand, MD, PhD</creator><creator>Serruys, Patrick W., MD, PhD</creator><creator>Fajadet, Jean, MD</creator><creator>Colombo, Antonio, MD, PhD</creator><creator>Carrié, Didier, MD, PhD</creator><creator>van Domburg, Ron T., PhD</creator><creator>de Jaegere, Peter P.T., MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20130115</creationdate><title>Effect of Body Mass Index on Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation</title><author>van der Boon, Robert M.A., MSc ; Chieffo, Alaide, MD ; Dumonteil, Nicolas, MD ; Tchetche, Didier, MD ; Van Mieghem, Nicolas M., MD ; Buchanan, Gill L., MBChB ; Vahdat, Olivier, MD ; Marcheix, Bertrand, MD, PhD ; Serruys, Patrick W., MD, PhD ; Fajadet, Jean, MD ; Colombo, Antonio, MD, PhD ; Carrié, Didier, MD, PhD ; van Domburg, Ron T., PhD ; de Jaegere, Peter P.T., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c561t-e67232680c028cf6d0f0f9c0567e6e996064ed6568aa2d343f51dee4657d30963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aortic Valve</topic><topic>Aortic Valve Stenosis - 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Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Boon, Robert M.A., MSc</au><au>Chieffo, Alaide, MD</au><au>Dumonteil, Nicolas, MD</au><au>Tchetche, Didier, MD</au><au>Van Mieghem, Nicolas M., MD</au><au>Buchanan, Gill L., MBChB</au><au>Vahdat, Olivier, MD</au><au>Marcheix, Bertrand, MD, PhD</au><au>Serruys, Patrick W., MD, PhD</au><au>Fajadet, Jean, MD</au><au>Colombo, Antonio, MD, PhD</au><au>Carrié, Didier, MD, PhD</au><au>van Domburg, Ron T., PhD</au><au>de Jaegere, Peter P.T., MD, PhD</au><aucorp>PRAGMATIC-Plus Researchers</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Body Mass Index on Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2013-01-15</date><risdate>2013</risdate><volume>111</volume><issue>2</issue><spage>231</spage><epage>236</epage><pages>231-236</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Better outcomes have been reported after percutaneous cardiac intervention in obese patients (“obesity paradox”). However, limited information is available on the effect of the body mass index on the outcomes after transcatheter aortic valve implantation (TAVI). We, therefore, sought to determine the effect of the body mass index on the short- and long-term outcomes in patients who underwent TAVI. The population consisted of 940 patients, of whom 25 (2.7%) were underweight, 384 had a (40.9%) normal weight, 372 (39.6%) were overweight, and 159 (16.9%) were obese. Overall, the obese patients were younger (79.7 ± 6.4 years vs 81.7 ± 7.3 and 80.8 ± 7.0 years, p = 0.008) and had a greater prevalence of preserved left ventricular and renal function. On univariate analysis, obese patients had a greater incidence of minor stroke (1.3% vs 0 and 0.3%, p = 0.03), minor vascular complications (15.7% vs 9.1% and 11.6%, p = 0.028) and acute kidney injury stage I (23.3% vs 10.7% and 16.1%, p <0.001). After adjustment, body mass index, as a continuous variable, was associated with a lower risk of mortality at 30 days (odds ratio 0.93, 95% confidence interval 0.86 to 0.98, p = 0.023) and no effect on survival after discharge (hazard ratio 1.01, 95% confidence interval 0.96 to 1.07, p = 0.73). In conclusion, obesity was associated with a greater incidence of minor, but no major, perioperative complications after TAVI. After adjustment, obesity was associated with a lower risk of 30-day mortality and had no adverse effect on mortality after discharge, underscoring the “obesity paradox” in patients undergoing TAVI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23102879</pmid><doi>10.1016/j.amjcard.2012.09.022</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aortic Valve Aortic Valve Stenosis - complications Aortic Valve Stenosis - mortality Aortic Valve Stenosis - surgery Body Mass Index Cardiac Catheterization - methods Cardiovascular Cardiovascular disease Drug therapy Europe - epidemiology Follow-Up Studies Heart attacks Heart Valve Prosthesis Hospital Mortality - trends Humans Kaplan-Meier Estimate Length of Stay Mortality Obesity Obesity - complications Obesity - mortality Odds Ratio Postoperative Period Risk Assessment - methods Risk Factors Time Factors Treatment Outcome |
| title | Effect of Body Mass Index on Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation |
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