The Relationship of Body Mass Index to Outcomes after Percutaneous Coronary Intervention

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Abstract
Objectives: To evaluate the effect of body mass index (BMI) on in‐hospital outcomes in patients undergoing percutaneous coronary intervention (PCI) at a tertiary care hospital center in Ontario, Canada. Background: Obesity is present in a large population of patients undergoing revascularization with PCI. Methods: Retrospective analysis of 4,631 patients aged 62.0 ± 12 years, stratified by BMI into five groups: nonobese (2); overweight (25–29.9 kg/m2); class I obese (30–34.9 kg/m2); class II obese (35–39.9 kg/m2); and class III obese (≥40 kg/m2). Results: A BMI >25 kg/m2 was present in 79% of patients, and 35% were obese (BMI ≥30 kg/m2). Obese patients, particularly the class III obese, were significantly younger and had higher prevalence of diabetes, hypertension, and dyslipidemia (P < 0.0001). After adjustment for several covariates, lower BMI was independently associated with higher risk of major bleeding requiring transfusion (adjusted odds ratio [OR]= 1.40, 95% confidence interval [CI] 1.04–1.88, P = 0.025), and femoral hematoma (adjusted OR = 1.14, 95% CI 1.05–1.25, P = 0.003) in lean (2) and normal BMI (20–24.9 kg/m2) patients. Obesity was not associated with death, myocardial infarction, repeat PCI, coronary artery bypass grafting, or major adverse cardiac event. Conclusions: Obesity is not associated with increased risk of adverse postprocedural in‐hospital outcomes. These findings, however, do not discount the need for sustained efforts in secondary prevention of obesity and its consequences.