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The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?



The obesity paradox in patients undergoing transcatheter aortic valve implantation: is there any effect of body mass index on survival?



Kardiologia Polska 2018



Conflicting results have been presented regarding influence of body mass index (BMI) on outcomes among patients undergoing transcatheter aortic valve implantation (TAVI). To investigate impact of the BMI on the clinical results after TAVI. A total of 148 consecutive patients were categorized using baseline BMI according to World Health Organization criteria. The baseline patient characteristics, frailty, procedural and clinical outcomes with 30 days and 12-month all-cause mortality were compared between BMI categories. Patients were followed-up for a median of 460.0 (182.0-1042.0) days. Obesity was diagnosed in 37 (25.2%) patients, 73 were overweight (49.7%), and 37 (25.2%) had normal weight. Lower frailty prevalence as assessed with 5-meter walking test was confirmed in obese patients as compared to other groups. A trend towards a lower rate of in-hospital bleeding complications [18 (48.6%) vs. 21 (28.8%) vs. 9 (24.3%); p = 0.06] and less frequent blood transfusions in overweight and obese was observed [18 (48.6%) vs. 17 [23.3%) vs. 8 (21.6%); p = 0.016]. The rate of grade 3 acute kidney injury was the lowest in the overweight group [4 (10.8%) vs. 1 (1.4%) vs. 3 (8.1%); p = 0.05]. There was no difference between groups in all-cause mortality at 30 days (p = 0.15). However, 12-month all-cause mortality was the lowest in obese patients [12 (32.4%) vs. 10 (13.7%) vs. 2 (5.4%); p = 0.004]. Increase in BMI was independently associated with lower all-cause mortality [HR (95%CI) per 1 kg/m² increase: 0.91 (0.845-0.98); p = 0.018]. Increased BMI was independently associated with survival benefit after TAVI.

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Accession: 066029089

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PMID: 30575008


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