Obesity paradox: Increased body mass index associated with improved survival in patients undergoing percutaneous coronary intervention
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Epidemiological data suggest that the increased cardiovascular risk ascribed to raising body mass index (BMI) may not systematically be applicable to older age groups. Data from the Scottish Coronary Revascularisation Register including all patients undergoing percutaneous coronary intervention (PCI) between April 1997 and March 2006 was used to investigate the impact of BMI on long-term all-cause mortality in patients after first-time elective PCI. Among the 4880 procedures performed, 219 deaths occurred within 5 years following PCI. Compared with normal-weight subjects, those presenting with a BMI ≥27.5 and <30 kg/m2 exhibited reduced death risk. After adjusting for confounding factors, the association between increased body weight and lowered death risk remained robust. When restricting the analysis to events beyond 30 days of follow-up, the results remained unaltered. These data suggest that in patients with established coronary artery disease, the adverse effects of excess adipose tissue may be offset by beneficial properties, representing thus another instance of “obesity paradox”.
Abstract
