The obesity paradox exists in Asia: A systematic review and meta-analysis of body mass index effects on clinical outcomes following percutaneous coronary intervention in Asia.

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Tzu Chi Medical Journal Pub Date : 2024-09-05 eCollection Date: 2024-10-01 DOI:10.4103/tcmj.tcmj_317_23
Andrianto, Chabib Fachry Albab, Nandha Pratama Mahardika
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Abstract

Cardiovascular diseases (CVDs) are major contributors to illness and death globally. Body mass index (BMI) is a well-established prognostic factor on cardiovascular risk outcome. Numerous investigations have provided evidence for the existence of the obesity paradox after percutaneous coronary intervention (PCI). However, the association between BMI and the results following PCI has not been extensively investigated in Asian populations. The research aims to fill the current void in understanding by investigating the association between BMI and clinical consequences following PCI, with a particular focus on Asian individuals. A systematic search was conducted through PubMed, ScienceDirect, and Cochrane Library to identify studies examining the effect of BMI on clinical outcome after PCI in Asia. R Studio 4.3.2 software was used to carry out the analysis of the data. A total of 182,110 patients who had gone through PCI were found in the 5 included cohorts. A meta-analysis conducted on the subjects revealed that patients who were overweight (odds ratio [OR] = 0.60, 95% confidence interval [CI] [0.57, 0.63], P < 0.0001) had a lower risk of all-cause mortality compared to individuals with a healthy weight and patients with obesity (OR = 0.65, 95% CI [0.41, 1.05], P = 0.006) had a lower risk of all-cause mortality than healthy weight individuals. The study also found that overweight patients (OR = 0.60, 95% CI [0.39, 0.91], P = 0.02) had a lower risk of cardiac mortality. In addition, obese patients (OR = 0.41, 95% CI [0.19, 0.88], P = 0.02) had a lower risk of noncardiac mortality. However, the study found that there were no differences in major adverse cardiovascular event, myocardial infarction, and bleeding between all patient groups. This meta-analysis supports the presence of an obesity paradox after PCI in Asian populations. The obesity paradox was evident in all-cause mortality, cardiac mortality, and noncardiac mortality.

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亚洲存在肥胖悖论:亚洲经皮冠状动脉介入治疗后体重指数对临床结果影响的系统回顾和荟萃分析。
心血管疾病(CVDs)是导致全球疾病和死亡的主要因素。体重指数(BMI)是心血管风险预后的一个公认因素。大量研究证明,经皮冠状动脉介入治疗(PCI)后存在肥胖悖论。然而,在亚洲人群中,BMI 与 PCI 术后结果之间的关系尚未得到广泛研究。本研究旨在通过调查 BMI 与 PCI 后临床后果之间的关系,填补目前的认识空白,尤其关注亚洲人。研究人员通过 PubMed、ScienceDirect 和 Cochrane Library 进行了系统性检索,以确定有关亚洲人 BMI 对 PCI 后临床结果影响的研究。数据分析使用了 R Studio 4.3.2 软件。在纳入的 5 个队列中,共有 182,110 名患者接受了 PCI 治疗。对受试者进行的荟萃分析表明,与体重健康的人相比,超重患者的全因死亡风险较低(几率比[OR] = 0.60,95% 置信区间[CI] [0.57, 0.63],P < 0.0001),而与体重健康的人相比,肥胖患者的全因死亡风险较低(OR = 0.65,95% 置信区间[CI] [0.41, 1.05],P = 0.006)。研究还发现,超重患者(OR = 0.60,95% CI [0.39,0.91],P = 0.02)的心脏死亡风险较低。此外,肥胖患者(OR = 0.41,95% CI [0.19,0.88],P = 0.02)的非心脏病死亡风险也较低。不过,研究发现,各组患者在主要不良心血管事件、心肌梗死和出血方面没有差异。这项荟萃分析支持亚洲人在接受 PCI 治疗后存在肥胖悖论。肥胖悖论在全因死亡率、心源性死亡率和非心源性死亡率方面都很明显。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tzu Chi Medical Journal
Tzu Chi Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
3.40
自引率
0.00%
发文量
44
审稿时长
13 weeks
期刊介绍: The Tzu Chi Medical Journal is the peer-reviewed publication of the Buddhist Compassion Relief Tzu Chi Foundation, and includes original research papers on clinical medicine and basic science, case reports, clinical pathological pages, and review articles.
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