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Impact of body mass index on the outcomes following transcatheter aortic valve implantation
Author(s) -
Abramowitz Yigal,
Chakravarty Tarun,
Jilaihawi Hasan,
Cox Justin,
Sharma Rahul P.,
Mangat Geeteshwar,
Nakamura Mamoo,
Cheng Wen,
Makkar Raj R.
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26394
Subject(s) - medicine , obesity paradox , overweight , body mass index , obesity , confounding , cardiology , diabetes mellitus , aortic valve stenosis , cohort , stenosis , surgery , endocrinology
Objectives To investigate the influence of body mass index (BMI) on short‐ and midterm outcomes following transcatheter aortic valve implantation (TAVI). Background Although obesity is a major risk factor for cardiovascular mortality, numerous studies reported a beneficial effect of obesity on survival in patients with cardiovascular disease and in patients after cardiac interventions. Moreover, all previous reports examining the relation between BMI and outcomes following TAVI have underscored the “obesity paradox” in these patients. Methods During a 3 year period, 805 patients with severe aortic stenosis that underwent TAVI at our institute were evaluated. Based on baseline BMI, patients were classified as normal weight (18.5–24.9 kg/m 2 ), overweight (25.0–29.9 kg/m 2 ), or obese (≥30 kg/m 2 ). TAVI endpoints, device success, and adverse events were considered according to the Valve Academic Research Consortium (VARC)−2 definitions. Results Obese patients were significantly younger, had higher prevalence of diabetes mellitus and chronic lung disease, and had lower prevalence of frailty. Device success was similar between the 3 groups. All‐cause mortality up to 30 days was 2.9% (10/340) vs 4.5% (12/268) vs 0.5% (1/186) in patients with normal weight, overweight, and obesity, respectively ( p = 0.048). In a multivariable model, overweight and obese patients had similar overall mortality compared to patients with normal weight. Conclusions We found no evidence for the existence of an obesity paradox following TAVI. Correction for possible confounders such as frailty in the present cohort may explain the discrepancy between the current report and the previous reports that suggested a protective effect for increased BMI following TAVI. © 2016 Wiley Periodicals, Inc.