Impact of body mass index on mortality, limb amputation, and bleeding in patients with lower extremity artery disease undergoing endovascular therapy.

IF 3.1 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Intervention and Therapeutics Pub Date : 2024-10-23 DOI:10.1007/s12928-024-01062-w
Takuya Nakahashi, Hayato Tada, Yasuaki Takeji, Shota Inaba, Masafumi Hashimoto, Akihiro Nomura, Kenji Sakata, Masayuki Takamura
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Abstract

The relation between Body Mass Index (BMI) and adverse outcomes after endovascular therapy (EVT) for patients with lower extremity artery disease (LEAD) remains incompletely understood. From April 2010 to March 2020, 199 consecutive patients who underwent EVT for LEAD were retrospectively analyzed. The patients were divided into three groups based on BMI; underweight < 18.5 kg/m2, normal weight ≥ 18.5 and < 25.0 kg/m2, and overweight ≥ 25.0 kg/m2. The endpoint of this study was a composite of all-cause mortality, major amputation, and major bleeding. Patients who were underweight often exhibited anemia (53.3 vs. 22.3 vs. 15.4%, respectively; p = 0.001) and severe chronic kidney disease (50.0 vs. 30.8 vs. 20.5%, respectively; p = 0.03). Furthermore, these patients had higher incidences of Trans-Atlantic Inter-Society Consensus class C or D lesions (40.0 vs. 20.0 vs. 10.3%, respectively; p = 0.01). During the median follow-up duration of 3.6 years (interquartile range: 1.2 to 6.7 years), there were 73 incidents of the composite endpoint. When the overweight group was assigned as the reference group, the adjusted hazard ratios for the composite endpoint for the underweight and normal weight patients were 3.67 (95% confidence interval [CI] 1.39-10.83, p = 0.008) and 2.35 (95% CI 1.06-6.23, p = 0.03), respectively. Kaplan-Meier curve demonstrated that the freedom from the composite endpoint for underweight, normal weight, and overweight patients was 41.6%, 60.0%, 83.8%, respectively (p < 0.001). These results suggest that there was an inverse association between BMI and adverse outcomes composed of mortality, limb amputation, and bleeding in patients with LEAD undergoing EVT.

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体重指数对接受血管内治疗的下肢动脉疾病患者的死亡率、截肢率和出血量的影响。
下肢动脉疾病(LEAD)患者接受血管内治疗(EVT)后,身体质量指数(BMI)与不良预后之间的关系仍不完全清楚。我们对 2010 年 4 月至 2020 年 3 月期间连续接受 EVT 治疗的 199 例 LEAD 患者进行了回顾性分析。根据体重指数将患者分为三组:体重不足2、正常体重≥18.5和2、超重≥25.0 kg/m2。这项研究的终点是全因死亡率、大截肢和大出血的综合指数。体重不足的患者通常会出现贫血(分别为 53.3% vs. 22.3% vs. 15.4%;P = 0.001)和严重慢性肾病(分别为 50.0% vs. 30.8% vs. 20.5%;P = 0.03)。此外,这些患者的跨大西洋学会间共识 C 级或 D 级病变发生率较高(分别为 40.0 对 20.0 对 10.3%;P = 0.01)。中位随访时间为 3.6 年(四分位间范围:1.2 年至 6.7 年),期间共发生 73 起综合终点事件。以超重组为参照组时,体重不足和体重正常患者的综合终点调整危险比分别为3.67(95% 置信区间[CI] 1.39-10.83,p = 0.008)和2.35(95% 置信区间 1.06-6.23,p = 0.03)。卡普兰-梅耶尔曲线显示,体重不足、体重正常和体重超重患者的复合终点自由度分别为 41.6%、60.0% 和 83.8%(P = 0.008)。
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来源期刊
Cardiovascular Intervention and Therapeutics
Cardiovascular Intervention and Therapeutics CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.30
自引率
12.50%
发文量
68
期刊介绍: Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.
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