The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: The obesity paradox?

Luis Gruberg*, Neil J. Weissman, Ron Waksman, Shmuel Fuchs, Regina Deible, Ellen E. Pinnow, Lanja M. Ahmed, Kenneth M. Kent, Augusto D. Pichard, William O. Suddath, Lowell F. Satler, Joseph Lindsay

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: The purpose of this study was to assess the impact of body mass index (BMI) on the short-and long-term outcomes after percutaneous coronary intervention (PCI). BACKGROUND: Obesity is associated with advanced coronary artery disease (CAD). However, the relation between BMI and outcome after PCI remains controversial. METHODS: We studied 9,633 consecutive patients who underwent PCI between January 1994 and December 1999. Patients were divided into three groups according to BMI: normal, BMI between 18.5 and 24.9 (n = 1,923); overweight, BMI between 25 and 30 (n = 4,813); and obese, BMI >30 (n = 2,897). RESULTS: Obese patients were significantly younger and had consistently worse baseline clinical characteristics than normal or overweight patients, with a higher incidence of hypertension, diabetes, hypercholesterolemia and smoking history (p < 0.0001). Despite similar angiographic success rates among the three groups, normal BMI patients had a higher incidence of major in-hospital complications, including cardiac death (p = 0.001). At one-year follow-up, overall mortality rates were significantly higher for normal BMI patients compared with overweight or obese patients (p < 0.0001). Myocardial infarction and revascularization rates did not differ among the three groups. By multivariate Cox regression analysis, diabetes, hypertension, age, BMI and left ventricular function were independent predictors of long-term mortality. CONCLUSIONS: In patients with known CAD who undergo PCI, very lean patients (BMI <18.5) and those with BMI within the normal range are at the highest risk for in-hospital complications and cardiac death and for increased one-year mortality.

Original languageEnglish
Pages (from-to)578-584
Number of pages7
JournalJournal of the American College of Cardiology
Issue number4
StatePublished - 20 Feb 2002
Externally publishedYes


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