Comparison of long-term mortality according to obesity in patients with successful percutaneous chronic total occlusion interventions using drug-eluting stents
- Author(s)
- Ki-Bum Won; Hyuck-Jun Yoon; Sang-Gon Lee; Yun-Kyeong Cho; Chang-Wook Nam; Seung-Ho Hur; Seung-Whan Lee; Pil-Hyung Lee; Jung-Min Ahn; Duk-Woo Park; Soo-Jin Kang; Young-Hak Kim; Cheol-Whan Lee; Seong-Wook Park; Seung-Jung Park
- Keimyung Author(s)
- Hur, Seung Ho; Nam, Chang Wook; Cho, Yun Kyeong; Yoon, Hyuck Jun
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Catheterization and Cardiovascular Interventions
- Issued Date
- 2018
- Volume
- 91
- Issue
- 4
- Keyword
- chronic total occlusion; drug-eluting stent; mortality; obesity
- 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.
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