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Mayo Clin Proc. 2014 Aug;89(8):1080-100. doi: 10.1016/j.mayocp.2014.04.020. Epub 2014 Jul 16.

Relationship of body mass index with total mortality, cardiovascular mortality, and myocardial infarction after coronary revascularization: evidence from a meta-analysis.

Author information

1
Department of Medicine, Maimonides Medical Center, Brooklyn, NY. Electronic address: abhisheksharma4mamc@gmail.com.
2
Division of Cardiology, University of Kansas Medical Center, Kansas City.
3
Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Medical Center, New York, NY.
4
Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans, LA; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge.
5
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD.
6
Division of Cardiology, Mayo College of Medicine, Rochester, MN.
7
Division of Cardiology, Texas Tech University, El Paso.
8
Department of Medicine, Maimonides Medical Center, Brooklyn, NY.

Abstract

OBJECTIVE:

To investigate the relationship of body mass index (BMI) with total mortality, cardiovascular (CV) mortality, and myocardial infarction (MI) after coronary revascularization procedures (coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]).

PATIENTS AND METHODS:

Systematic search of studies was conducted using PubMed, CINAHL, Cochran CENTRAL, Scopus, and the Web of Science databases. We identified studies reporting the rate of MI, CV mortality, and total mortality among coronary artery disease patients' postcoronary revascularization procedures in various BMI categories: less than 20 (underweight), 20-24.9 (normal reference), 25-29.9 (overweight), 30-34.9 (obese), and 35 or more (severely obese). Event rates were compared using a random effects model assuming interstudy heterogeneity.

RESULTS:

A total of 36 studies (12 CABG; 26 PCI) were selected for final analyses. The risk of total mortality (relative risk [RR], 2.59; 95% CI, 2.09-3.21), CV mortality (RR, 2.67; 95% CI, 1.63-4.39), and MI (RR, 1.79; 95% CI, 1.28-2.50) was highest among patients with low BMI at the end of a mean follow-up period of 1.7 years. The risk of CV mortality was lowest among overweight patients (RR, 0.81; 95% CI, 0.68-0.95). Increasing degree of adiposity as assessed by BMI had a neutral effect on the risk of MI for overweight (RR, 0.92; 95% CI, 0.84-1.01), obese (RR, 0.99; 95% CI, 0.85-1.15), and severely obese (RR, 0.93; 95% CI, 0.78-1.11) patients.

CONCLUSION:

After coronary artery disease revascularization procedures (PCI and CABG), the risk of total mortality, CV mortality, and MI was highest among underweight patients as defined by low BMI and CV mortality was lowest among overweight patients.

Comment in

PMID:
25039038
DOI:
10.1016/j.mayocp.2014.04.020
[Indexed for MEDLINE]
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