The relationship of body mass index to outcomes after percutaneous coronary intervention

J Interv Cardiol. 2006 Oct;19(5):388-95. doi: 10.1111/j.1540-8183.2006.00189.x.


Objectives: To evaluate the effect of body mass index (BMI) on in-hospital outcomes in patients undergoing percutaneous coronary intervention (PCI) at a tertiary care hospital center in Ontario, Canada.

Background: Obesity is present in a large population of patients undergoing revascularization with PCI.

Methods: Retrospective analysis of 4,631 patients aged 62.0 +/- 12 years, stratified by BMI into five groups: nonobese (<25 kg/m2); overweight (25-29.9 kg/m2); class I obese (30-34.9 kg/m2); class II obese (35-39.9 kg/m2); and class III obese (> or =40 kg/m2).

Results: A BMI >25 kg/m2 was present in 79% of patients, and 35% were obese (BMI > or =30 kg/m2). Obese patients, particularly the class III obese, were significantly younger and had higher prevalence of diabetes, hypertension, and dyslipidemia (P < 0.0001). After adjustment for several covariates, lower BMI was independently associated with higher risk of major bleeding requiring transfusion (adjusted odds ratio [OR]= 1.40, 95% confidence interval [CI] 1.04-1.88, P = 0.025), and femoral hematoma (adjusted OR = 1.14, 95% CI 1.05-1.25, P = 0.003) in lean (<20 kg/m2) and normal BMI (20-24.9 kg/m2) patients. Obesity was not associated with death, myocardial infarction, repeat PCI, coronary artery bypass grafting, or major adverse cardiac event.

Conclusions: Obesity is not associated with increased risk of adverse postprocedural in-hospital outcomes. These findings, however, do not discount the need for sustained efforts in secondary prevention of obesity and its consequences.

MeSH terms

  • Aged
  • Analysis of Variance
  • Angioplasty, Balloon, Coronary*
  • Body Mass Index*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Ontario / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome