OBJECTIVES: We aimed to determine whether body mass index (BMI) is a prognostic indicator for long-term, all-cause mortality in patients undergoing transcatheter aortic valve implantation (TAVI). BACKGROUND: Obesity in patients with established cardiovascular disease has previously been identified as an indicator of good prognosis, a phenomenon known as the "obesity paradox". The prognostic significance of BMI in patients with severe aortic stenosis (AoS) undergoing TAVI is a matter of current debate, as published studies are scarce and their results conflicting. METHODS: This is an observational, retrospective study involving 770 patients who underwent TAVI for AoS. The cohort was divided into three groups based on their BMI: normal weight (≥18.5 to <25kg/m2), overweight (≥25 to <30kg/m2) and obese (≥30kg/m2). The predictive effect of BMI on all-cause mortality 3years following TAVI intervention was analysed using a Cox regression. RESULTS: 155 patients died during follow-up. The overweight group (n=302, 38.97%), experienced a lower mortality rate compared to the normal weight and obese groups (15.9% vs 25.7% and 21.0%, respectively [log-rank p-value=0.036]). After adjustment by logistic EuroSCORE, being overweight was found to be an independent protective factor against mortality (HR: 0.63 [95% CI: 0.42 to 0.94], p=0.024). This was not the case for obesity (HR: 0.92 [95% CI: 0.63 to 1.35], p=0.664). We therefore describe for the first time, a "J-shaped" regression curve describing the relationship between BMI and mortality. CONCLUSIONS: BMI is a predictive factor of all-cause mortality in AoS patients undergoing TAVI. This relationship takes the form of a "J-shaped" curve in which overweight patients are associated with the lowest mortality rate at follow-up. Copyright Â
OBJECTIVES: We aimed to determine whether body mass index (BMI) is a prognostic indicator for long-term, all-cause mortality in patients undergoing transcatheter aortic valve implantation (TAVI). BACKGROUND:Obesity in patients with established cardiovascular disease has previously been identified as an indicator of good prognosis, a phenomenon known as the "obesity paradox". The prognostic significance of BMI in patients with severe aortic stenosis (AoS) undergoing TAVI is a matter of current debate, as published studies are scarce and their results conflicting. METHODS: This is an observational, retrospective study involving 770 patients who underwent TAVI for AoS. The cohort was divided into three groups based on their BMI: normal weight (≥18.5 to <25kg/m2), overweight (≥25 to <30kg/m2) and obese (≥30kg/m2). The predictive effect of BMI on all-cause mortality 3years following TAVI intervention was analysed using a Cox regression. RESULTS: 155 patients died during follow-up. The overweight group (n=302, 38.97%), experienced a lower mortality rate compared to the normal weight and obese groups (15.9% vs 25.7% and 21.0%, respectively [log-rank p-value=0.036]). After adjustment by logistic EuroSCORE, being overweight was found to be an independent protective factor against mortality (HR: 0.63 [95% CI: 0.42 to 0.94], p=0.024). This was not the case for obesity (HR: 0.92 [95% CI: 0.63 to 1.35], p=0.664). We therefore describe for the first time, a "J-shaped" regression curve describing the relationship between BMI and mortality. CONCLUSIONS: BMI is a predictive factor of all-cause mortality in AoS patients undergoing TAVI. This relationship takes the form of a "J-shaped" curve in which overweight patients are associated with the lowest mortality rate at follow-up. Copyright Â
Authors: M Abawi; R Rozemeijer; P Agostoni; R C van Jaarsveld; C S van Dongen; M Voskuil; A O Kraaijeveld; P A F M Doevendans; P R Stella Journal: Neth Heart J Date: 2017-09 Impact factor: 2.380
Authors: Astrid C van Nieuwkerk; Raquel B Santos; Samantha Sartori; Ander Regueiro; Didier Tchétché; Roxana Mehran; Ronak Delewi Journal: JTCVS Open Date: 2021-03-23
Authors: M S van Mourik; J F Velu; V R Lanting; J Limpens; B J Bouma; J J Piek; J Baan; J P S Henriques; M M Vis Journal: Neth Heart J Date: 2020-05 Impact factor: 2.380