Is Body Mass Index a Risk Factor for Isolated Off‐Pump Coronary Revascularization?

  Objective : The influence of body mass index (BMI) as a risk factor for isolated off‐pump coronary artery bypass (OPCAB) surgery is unknown. We postulated that BMI ≥ 30 kg/m 2 would adversely affect outcomes following OPCAB at our institution. Methods : From 2002 to 2009, we selected 742 patients (primary, N = 709 [95.6%], re‐operative, N = 33 [4.45%]) who underwent isolated OPCAB for analysis. Patients were stratified into groups by BMI: non‐obese (BMI < 30 kg/m 2 ) and obese (BMI ≥ 30 kg/m 2 ). Preoperative risk, operative characteristics, and postoperative outcomes were analyzed. Risk‐adjusted models evaluated the occurrence of any complication and mortality. Results : Overall crude mortality was 1.5% (11/742). When compared to non‐obese (26.12 ± 2.72 kg/m 2 ) recipients, the obese (35.81 ± 5.69 kg/m 2 ) comprised younger patients (62.46 ± 9.96 years, p < 0.001). Number of diseased vessels, Left ventricular ejection fraction, and baseline renal function was equivalent across groups. Diabetes (53.24%) and hypertension (90.59%) were more prevalent among obese patients (p < 0.001, respectively). Internal mammary artery utilization (p = 0.47), endoscopic vein harvest (p = 0.74), and intra‐aortic balloon pump use (p = 0.58) were similar between groups. Interestingly, postoperative blood product requirement was lower in obese versus non‐obese recipients (47.35% vs. 56.72%, p < 0.01). Furthermore, intensive care unit stay (p = 0.93), mortality (p = 0.56), and discharge to home (p = 0.09) remained equivalent between groups. Importantly, multivariable logistic regression did not identify BMI ≥ 30 kg/m 2 as an independent predictor of any complication (p = 0.21) or mortality (p = 0.74). Conclusions : Obesity does not influence operative characteristics or effect outcomes after OPCAB. BMI ≥ 30 kg/m 2 should not be considered a prohibitive risk factor in isolated off‐pump coronary revascularization. (J Card Surg 2011;26:565‐571)