摘要
Background：The impact of body mass index （BMI） on the clinical outcomes after percutaneous coronary intervention （PCI） in patients ≥75 years old remained unclear.Methods：A total of 1098 elderly patients undergoing PCI with stent implantation were recruited.Patients were divided into four groups by the value of BMI：Underweight （〈20.0 kg/m^2）,normal weight （20.0-24.9 kg/m^2）,overweight （25.0-29.9 kg/m^2） and obese （≥30.0 kg/m^2）.Major clinical outcomes after PCI were compared between the groups.The primary endpoint was defined as in-hospital major adverse cardiovascular events （MACEs）,which included death,myocardial infarction （MI） and target vessel revascularization.The secondary endpoint was defined as 1 year death.Logistic regression analysis was performed to adjust for the potential confounders.Results：Totally,1077 elderly patients with available BMIs were included in the analysis.Patients of underweight,normal weight,overweight and obese accounted for 5.6%,45.4%,41.5% and 7.5% of the population,respectively.Underweight patients were more likely to attract ST-segment elevation MI,and get accompanied with anemia or renal dysfunction.Meanwhile,they were less likely to achieve thrombolysis in MI 3 grade flow after PCI,and receive beta-blocker,angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge.In underweight,normal weight,overweight and obese patients,in-hospital MACE were 1.7%,2.7%,3.8%,and 3.7% respectively （P =0.68）,and 1 year mortality rates were 5.0%,3.9%,5.1% and 3.7% （P =0.80）,without significant difference between the groups.Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old.Conclusions：The BMI ＂obese paradox＂ was not found in patients ≥75 years old.It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients.
Background：The impact of body mass index （BMI） on the clinical outcomes after percutaneous coronary intervention （PCI） in patients ≥75 years old remained unclear.Methods：A total of 1098 elderly patients undergoing PCI with stent implantation were recruited.Patients were divided into four groups by the value of BMI：Underweight （〈20.0 kg/m^2）,normal weight （20.0-24.9 kg/m^2）,overweight （25.0-29.9 kg/m^2） and obese （≥30.0 kg/m^2）.Major clinical outcomes after PCI were compared between the groups.The primary endpoint was defined as in-hospital major adverse cardiovascular events （MACEs）,which included death,myocardial infarction （MI） and target vessel revascularization.The secondary endpoint was defined as 1 year death.Logistic regression analysis was performed to adjust for the potential confounders.Results：Totally,1077 elderly patients with available BMIs were included in the analysis.Patients of underweight,normal weight,overweight and obese accounted for 5.6%,45.4%,41.5% and 7.5% of the population,respectively.Underweight patients were more likely to attract ST-segment elevation MI,and get accompanied with anemia or renal dysfunction.Meanwhile,they were less likely to achieve thrombolysis in MI 3 grade flow after PCI,and receive beta-blocker,angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge.In underweight,normal weight,overweight and obese patients,in-hospital MACE were 1.7%,2.7%,3.8%,and 3.7% respectively （P =0.68）,and 1 year mortality rates were 5.0%,3.9%,5.1% and 3.7% （P =0.80）,without significant difference between the groups.Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old.Conclusions：The BMI ＂obese paradox＂ was not found in patients ≥75 years old.It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients.
