Journal Article

Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention

Miyahara, Hirofumi, Yamazaki, Tatsuro, Kitahara, Hideki, Sano, Masanori, Asano, Tatsuhiko, Yamamoto, Masashi, Ohno, Yuji, Hiraga, Takashi, Kuriyama, Nehiro, Kobayashi, Takahiro, Harada, Junya, Fukushima, Kenichi, Sakamoto, Naoya, Yamashita, Daichi, Ishio, Naoki, Matsumoto, Tadahiro, Kobayashi, Yoshio, Sato, Takanori, Suzuki, Sakuramaru, Uchiyama, Raita, Okino, Shinichi, Kanda, Junji

2024

Overview

It is still unclear whether body mass index (BMI) affects bleeding and cardiovascular events in patients requiring oral anticoagulants (OAC) for atrial fibrillation (AF) and antiplatelet agents after percutaneous coronary intervention (PCI) for coronary artery disease (CAD). The aim of this study was to evaluate the relationship between BMI and clinical events in patients who underwent PCI under OAC therapy for AF. This was a multicenter, observational cohort study conducted at 15 institutions in Japan. AF patients who underwent PCI with drug-eluting stents for CAD were retrospectively and prospectively included. Patients were divided into the Group 1 (BMI <21.3 kg/m2) and the Group 2 (BMI ≥21.3 kg/m2) according to the first-quartile value of BMI. The primary endpoint was net adverse clinical events (NACE), a composite of major adverse cardiovascular events (MACE) and major bleeding events within one year after index PCI procedure. In the 720 patients, 180 patients (25.0%) had BMI value <21.3 kg/m2. While the rates of NACE and MACE were significantly higher in the Group 1 than the counterpart (21.1% vs. 11.9%, p = 0.003 and 17.2% vs. 8.9%, p = 0.004), that of major bleeding did not differ significantly between the 2 groups (5.6% vs. 4.3%, p = 0.54). The cumulative rate of NACE and MACE was significantly higher in the Group 1 than the Group 2 (both log-rank p = 0.002), although that of major bleeding events was equivalent between the 2 groups (log-rank p = 0.41). In multivariable Cox regression analyses, while BMI value <21.3 kg/m2 was not associated with major bleeding events, that cut-off value was an independent predictor for increased NACE and MACE. Among the patients undergoing PCI for CAD and requiring OAC for AF, BMI value was a useful indicator to predict major adverse clinical events.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Aged, 80 and over / Angioplasty / Anticoagulants / Anticoagulants - administration & dosage / Anticoagulants - adverse effects / Anticoagulants - therapeutic use / Antiplatelet therapy / Atrial fibrillation / Atrial Fibrillation - drug therapy / Biology and Life Sciences / Bleeding / Body Mass Index / Body size / Cardiac arrhythmia / Cardiovascular disease / Care and treatment / Chronic illnesses / Coronary artery disease / Coronary Artery Disease - complications / Coronary Artery Disease - surgery / Coronary Artery Disease - therapy / Coronary vessels / Diabetes / Diagnosis / Drug delivery / Drug dosages / Drug-Eluting Stents - adverse effects / Female / Fibrillation / Health aspects / Heart diseases / Hemoglobin / Hemorrhage - etiology / Humans / Hypertension / Implants / Japan - epidemiology / Male / Medical prognosis / Medicine and Health Sciences / Metabolic disorders / Middle Aged / Mortality / Observational studies / Percutaneous Coronary Intervention - adverse effects / Platelet Aggregation Inhibitors - adverse effects / Platelet Aggregation Inhibitors - therapeutic use / Regression analysis / Retrospective Studies / Risk Factors / Stents / Thrombosis / Variance analysis / Vein & artery diseases