JTCVS Open (Jun 2021)

Impact of body mass index on outcomes in patients undergoing transfemoral transcatheter aortic valve implantationCentral MessagePerspective

  • Astrid C. van Nieuwkerk, MD,
  • Raquel B. Santos, MD,
  • Samantha Sartori, PhD,
  • Ander Regueiro, MD,
  • Didier Tchétché, MD,
  • Roxana Mehran, MD,
  • Ronak Delewi, MD, PhD,
  • Flavio S. De Brito, Jr., MD, PhD,
  • Flavio Tarasoutchi, MD,
  • Marco Barbanti, MD,
  • Ran Kornowski, MD,
  • Katia Orvin, MD,
  • Azeem Latib, MD,
  • Matteo Pagnesi, MD,
  • Augusto D'Onofrio, MD, PhD,
  • Giuseppe Tarantini, MD, PhD,
  • Flavio Ribichini, MD, PhD,
  • Mattia Lunardi, MD,
  • Jan Baan, MD, PhD,
  • Jan Tijssen, PhD,
  • José P.S. Henriques, MD, PhD,
  • Francisco Ten,
  • Nicolas Dumonteil, MD,
  • Angie Ghattas, MD,
  • Paola D'Errigo, MSc,
  • Juan Manuel Nogales,
  • Thomas Modine, MD,
  • George Dangas, MD, PhD

Journal volume & issue
Vol. 6
pp. 26 – 36

Abstract

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Objective: This study sought to investigate the effect of body mass index on outcomes in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation. Methods: A total of 12,381 patients undergoing transfemoral transcatheter aortic valve implantation were divided into body mass index categories: underweight (30 kg/m2). Primary endpoints were differences in 30-day and 1-year all-cause mortality. Secondary endpoints included all other clinical endpoints such as stroke. Univariate and multivariate odds ratios were calculated using logistic and cox regression analyses. Results: Two percent (n = 205) of patients were underweight, 29% (n = 3564) were normal weight, 44% (n = 5460) were overweight, and 25% (n = 3152) were obese. Thirty-day mortality was lower in overweight (5.3%, odds ratio, 0.73; 95% confidence interval, 0.61-0.88; P = .001) and obese patients (5.2%, odds ratio, 0.74; 95% confidence interval, 0.60-0.92; P = .006), but higher in underweight (9.8%, odds ratio, 1.51; 95% confidence interval, 0.92-2.47; P = .010) as compared to normal weight patients (6.9%). After multivariate adjustment, 30-day mortality was not significantly different across body mass index categories. However, 1-year mortality was higher in underweight patients (hazard ratio, 1.52; 95% confidence interval, 1.10-2.09; P = .011). Stroke rates were comparable between body mass index groups. Conclusions: For overweight and obese patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation, there was no 30-day difference in mortality compared with patients with normal weight. However, underweight patients showed higher rates of 1-year mortality after transcatheter aortic valve implantation.

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