The relationship of obesity to ischemic outcomes following coronary stent placement in contemporary practice

Catheter Cardiovasc Interv. 2006 Apr;67(4):563-70. doi: 10.1002/ccd.20622.


Objectives: We analyzed the relationship of obesity, determined by body mass index (BMI), to short- and long-term outcomes in the TARGET trial.

Background: : Previous studies have conflicting findings regarding the relationship of BMI to outcomes following percutaneous coronary intervention (PCI).

Methods: The TARGET trial studied the use of glycoprotein (GP) IIb/IIIa inhibition in patients undergoing planned coronary stent placement.

Results: Eighty-one percent of all patients were overweight (BMI > 25), 36% were obese (BMI > 30), and United States patients were more frequently obese (38.7% vs. 25.8%, P < 0.001). Obese patients had a similar 30-day ischemic event rate compared with nonobese patients, but less major bleeding (0.4% vs. 1.1%, P = 0.013). Six-month death and myocardial infarction rates were similar in obese and nonobese patients. There was a J-shaped relationship between 6-month target vessel revascularization (TVR) and BMI with the lowest incidence of TVR at BMI 27.5. Six-month TVR was higher in the morbidly (BMI > 35) obese (12.4% vs 8.7%, P < 0.05). In extremely (BMI > 32) obese patients, this relationship was more significant (TVR 11.3% vs. 8.5%, P = 0.007), particularly in patients <65 years of age (TVR 12.3% vs. 8.4%, P = 0.003).

Conclusion: The majority of patients undergoing PCI are overweight, especially in the United States. Extreme obesity is associated with a significant increase in TVR following intent-to-stent PCI, especially in patients <65 years of age. With routine use of GP IIb/IIIa inhibitors, other long- and short-term ischemic events are similar in obese and nonobese patients. However, obese patients have significantly less major bleeding.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary*
  • Anticoagulants / administration & dosage
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Metals
  • Middle Aged
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / mortality
  • Myocardial Ischemia / therapy*
  • Obesity / complications*
  • Obesity / epidemiology
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
  • Stents*
  • Treatment Outcome


  • Anticoagulants
  • Metals
  • Platelet Glycoprotein GPIIb-IIIa Complex