Open AccessThe Obesity Paradox in Patients Undergoing Transcatheter Aortic Valve Implantation
Author(s) -
Konigstein Maayan,
Havakuk Ofer,
Arbel Yaron,
Finkelstein Ariel,
BenAssa Eyal,
Leshem Rubinow Eran,
Abramowitz Yigal,
Keren Gad,
Banai Shmuel
Publication year - 2015
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22355
Subject(s) - medicine , overweight , underweight , body mass index , hazard ratio , obesity , obesity paradox , confidence interval , population , cardiology , incidence (geometry) , risk factor , surgery , physics , environmental health , optics
Background Obesity is a major risk factor for cardiovascular morbidity and mortality. A considerable number of studies, however, showed better outcomes for overweight patients undergoing cardiovascular interventions—the so called obesity paradox . Hypothesis Increased body mass index ( BMI ) is independently associated with improved survival following transcatheter aortic valve implantation ( TAVI ). Methods We analyzed the data of 409 consecutive patients undergoing TAVI in our medical center. Patients were categorized into 4 groups according to BMI : underweight (≤18.4 kg/m 2 ), normal weight (18.5–24.9 kg/m 2 ), overweight (25–29.9 kg/m 2 ), and obese (≥30 kg/m 2 ). Procedure‐related complications were recorded, as well as 30‐day and 1‐year all‐cause mortality rates. Results Obese patients had a higher prevalence of comorbidities and higher incidence of vascular complications compared with the normal‐weight patients (16% vs 7%, P = 0.013). Nevertheless, 30‐day mortality was similar among the groups, whereas 1‐year mortality was lower among the overweight and obese patients ( BMI >25) ( P = 0.038). After adjusting for differences in baseline characteristics, increase in BMI was found to be independently associated with improved survival following TAVI (hazard ratio: 0.94, confidence interval: 0.89‐0.99, P = 0.043). Conclusions In our single‐center study, obesity and overweight were independently associated with better outcome, supporting the obesity paradox in the TAVI population.