Potential confounders of the obesity paradox in older patients following transcatheter aortic valve replacement

Key Summary Points Aim The present study aimed to investigate potential confounders of the obesity paradox in older patients following transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. Findings The obesity paradox was observed in older patients following TAVR. Cachexia may reflect higher mortality in patients with lower BMI and higher subcutaneous fat accumulation (SFA) may represent lower mortality in those with higher BMI. Message Considering higher mortality in lower BMI with cachexia, prevention or treatment of the comorbidity would be important in older patients following TAVR. Purpose A higher body mass index (BMI) is associated with lower mortality in older patients following transcatheter aortic valve replacement (TAVR) for severe aortic valve stenosis. The current study aimed to investigate potential confounders of association between BMI and prognosis. Methods The retrospective single-center study included consecutive patients following TAVR and excluded those in whom subcutaneous fat accumulation (SFA), visceral fat accumulation (VFA), and major psoas muscle (MPM) volume were not assessed by computed tomography. Cachexia was defined as a combination of BMI