Comparison of long-term mortality according to obesity in patients with successful percutaneous chronic total occlusion interventions using drug-eluting stents

Authors
Ki-Bum WonHyuck-Jun YoonSang-Gon LeeYun-Kyeong ChoChang-Wook NamSeung-Ho HurSeung-Whan LeePil-Hyung LeeJung-Min AhnDuk-Woo ParkSoo-Jin KangYoung-Hak KimCheol-Whan LeeSeong-Wook ParkSeung-Jung Park
Department
Dept. of Internal Medicine (내과학)
Issue Date
2018
Citation
Catheterization and Cardiovascular Interventions, Vol.91(4) : 710-716, 2018
ISSN
1522-1946
Abstract
OBJECTIVE: To evaluate the long-term mortality according to obesity in patients with chronic total occlusion (CTO) lesions after successful percutaneous coronary intervention (PCI). BACKGROUND: Despite the potential impact of coronary revascularization and lesion severity on the obesity paradox, the long-term survival according to obesity in CTO patients after successful PCI has been unknown. METHODS AND RESULTS: Between January 2003 and September 2014, we examined 1,172 consecutive Korean patients with 1,190 CTO lesions who underwent successful drug-eluting stent (DES) implantation in two tertiary academic medical centers. The primary and secondary endpoints were all-cause and cardiac death, respectively. Obesity was defined as a body mass index ≥25.0 kg/m2 , based on the criteria for Asians. The median follow-up time was 4.4 years. The prevalence of obesity was 54.4%. During the follow-up periods, the occurrence of all-cause (6.1 vs. 10.7%) and cardiac death (3.8 vs. 6.7%) was lower in obese patients than in non-obese patients (P <0.05, respectively). Kaplan-Meier analysis showed that obese patients had lower cumulative rates of all-cause and cardiac death than did non-obese patients (log-rank P <0.05, respectively). Univariate Cox regression analysis showed that age ≥65 years (hazard ratio [HR], 3.62), diabetes mellitus (HR, 1.94), renal dysfunction (HR, 7.03), systolic heart failure (HR, 2.61), and obesity (HR, 0.58) were associated with all-cause death (P <0.05). Multivariate Cox regression models showed that high BMI was independently associated with the decreased risk of all-cause death. CONCLUSIONS: Obese patients appear to have a lower long-term mortality than do non-obese patients in CTO after successful PCI using DES. © 2017 Wiley Periodicals, Inc.
Keywords
chronic total occlusiondrug-eluting stentmortalityobesity
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41152
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
허승호; 남창욱; 조윤경; 윤혁준
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1002/ccd.27110
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