OBJECTIVES: The aim of this study was to compare clinical outcomes among unselected patients stratified in categories of body mass index, who underwent percutaneous coronary intervention (PCI) with either sirolimus-eluting or paclitaxel-eluting stents. BACKGROUND: Overweight and obesity are often considered risk factors for cardiovascular events. However, recent studies have associated obesity with better outcomes after PCI with bare-metal stents. Data from routine clinical practice using drug-eluting stents (DES) focusing on this "obesity paradox" are not available. METHODS: We used data from DES.DE (German Drug-Eluting Stent) registry to compare in-hospital and 1-year outcomes among unselected patients undergoing PCI with DES implantation. Primary endpoints were the rate of major adverse cardiac and cerebrovascular events (MACCE) (defined as the composite of death, myocardial infarction, and stroke) and target vessel revascularization (TVR). RESULTS: Between October 2005 and 2006, 1,436 normal weight, 2,839 overweight, and 1,531 obese patients treated with DES were enrolled at 98 sites. Baseline clinical parameters were more severe in overweight and obese patients; 1-year follow-up comparison between groups revealed similar rates of all-cause death (3.3% vs. 2.4% vs. 2.4%; p=0.17), MACCE (7.1% vs. 5.6% vs. 5.5%; p=0.09), and TVR in survivors (10.9% vs. 11.7% vs. 11.6%; p=0.56) in normal weight individuals compared with overweight or obese patients. Such results persisted after risk-adjustment for heterogeneous baseline characteristics of groups and were independent of the types of DES. CONCLUSIONS: DES.DE revealed no evidence of "obesity paradox" in a routine clinical practice using DES.
OBJECTIVES: The aim of this study was to compare clinical outcomes among unselected patients stratified in categories of body mass index, who underwent percutaneous coronary intervention (PCI) with either sirolimus-eluting or paclitaxel-eluting stents. BACKGROUND: Overweight and obesity are often considered risk factors for cardiovascular events. However, recent studies have associated obesity with better outcomes after PCI with bare-metal stents. Data from routine clinical practice using drug-eluting stents (DES) focusing on this "obesity paradox" are not available. METHODS: We used data from DES.DE (German Drug-Eluting Stent) registry to compare in-hospital and 1-year outcomes among unselected patients undergoing PCI with DES implantation. Primary endpoints were the rate of major adverse cardiac and cerebrovascular events (MACCE) (defined as the composite of death, myocardial infarction, and stroke) and target vessel revascularization (TVR). RESULTS: Between October 2005 and 2006, 1,436 normal weight, 2,839 overweight, and 1,531 obesepatients treated with DES were enrolled at 98 sites. Baseline clinical parameters were more severe in overweight and obesepatients; 1-year follow-up comparison between groups revealed similar rates of all-cause death (3.3% vs. 2.4% vs. 2.4%; p=0.17), MACCE (7.1% vs. 5.6% vs. 5.5%; p=0.09), and TVR in survivors (10.9% vs. 11.7% vs. 11.6%; p=0.56) in normal weight individuals compared with overweight or obesepatients. Such results persisted after risk-adjustment for heterogeneous baseline characteristics of groups and were independent of the types of DES. CONCLUSIONS: DES.DE revealed no evidence of "obesity paradox" in a routine clinical practice using DES.
Authors: Gilson Soares Feitosa-Filho; José Maria Peixoto; José Elias Soares Pinheiro; Abrahão Afiune Neto; Afonso Luiz Tavares de Albuquerque; Álvaro César Cattani; Amit Nussbacher; Ana Amelia Camarano; Angela Hermínia Sichinels; Antonio Carlos Sobral Sousa; Aristóteles Comte de Alencar Filho; Claudia F Gravina; Dario Celestino Sobral Filho; Eduardo Pitthan; Elisa Franco de Assis Costa; Elizabeth da Rosa Duarte; Elizabete Viana de Freitas; Emilio Hideyuki Moriguchi; Evandro Tinoco Mesquita; Fábio Fernandes; Gilson Soares Feitosa; Humberto Pierre; Ilnei Pereira Filho; Izo Helber; Jairo Lins Borges; Jéssica Myrian de Amorim Garcia; José Antonio Gordillo de Souza; José Carlos da Costa Zanon; Josmar de Castro Alves; Kalil Lays Mohallem; Laura Mariana de Siqueira Mendonça Chaves; Lídia Ana Zytynski Moura; Márcia Cristina Amélia da Silva; Maria Alice de Vilhena Toledo; Maria Elisa Lucena Sales de Melo Assunção; Mauricio Wajngarten; Mauro José Oliveira Gonçalves; Neuza Helena Moreira Lopes; Nezilour Lobato Rodrigues; Paulo Roberto Pereira Toscano; Pedro Rousseff; Ricardo Antonio Rosado Maia; Roberto Alexandre Franken; Roberto Dischinger Miranda; Roberto Gamarski; Ronaldo Fernandes Rosa; Silvio Carlos de Moraes Santos; Siulmara Cristina Galera; Stela Maris da Silva Grespan; Teresa Cristina Rogerio da Silva; William Antonio de Magalhães Esteves Journal: Arq Bras Cardiol Date: 2019-06-06 Impact factor: 2.000
Authors: Rahul Chaudhary; Kevin P Bliden; Udaya S Tantry; Nafees Mohammed; Denny Mathew; Martin G Gesheff; Christopher J Franzese; Paul A Gurbel Journal: J Thromb Thrombolysis Date: 2016-04 Impact factor: 2.300