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Body Mass Index and 10-Year Clinical Outcomes After Percutaneous Coronary Intervention—Interaction with Age, Sex, Diabetic Status and Clinical Presentation

Year: 2025

Type: article

Abstract: Background and Aims: The association between body mass index (BMI) and long-term outcome after percutaneous coronary intervention (PCI) remains poorly inves-tigated. We undertook this study to assess the association between BMI and 10-year out-come after PCI. Methods and Results: This study included 5597 patients with coronary artery disease undergoing PCI. Patients were categorized according to BMI values: un-derweight group (BMI <18.5 kg/m2), normal weight group (BMI between 18.5 kg/m2 and <25 kg/m2), overweight group (BMI between 25 kg/m2 and <30 kg/m2) and obesity group (BMI ≥30 kg/m2). The primary outcome was 10-year all-cause mortality. At 10 years, deaths of any cause (primary endpoint) occurred in 1754 patients: 31 deaths in the under-weight group (59.7%), 582 deaths (39.1%) in the normal weight group, 710 deaths (31.1%) in the overweight group and 431 deaths (33.8%) in the obesity group (overall P value <0.001; P for nonlinearity <0.001). Nonsurvivors had a significantly lower BMI compared with survivors (26.5 [24.2-29.9] kg/m2 vs. 27.2 [24.8-30.1] kg/m2, P<0.001). Interaction test-ing showed a BMI-by-age interaction demonstrating a stronger association between higher BMI (≥25 kg/m2) and reduced risk of all-cause mortality in patients ≥75 years of age (Pint = 0.009). The association between BMI and all-cause mortality was U-shaped (P for nonlinearity<0.001). C-statistic of the multivariable Cox proportional hazards model for mortality increased from 0.762 [0.751-0.773] with baselines variables only to 0.766 [0.756-0.777], P<0.001) after inclusion of BMI in the model (baseline variables plus BMI). Conclu-sions BMI was associated with 10-year mortality after PCI with a U-shaped relationship.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14051413