Association Between Body Mass Index and Clinical Outcomes According to Diabetes in Patients Who Underwent Percutaneous Coronary Intervention

Overview

Journal Korean Circ J

Date 2023 Nov 17

PMID 37973975

Authors

Byung Gyu Kim

Sung-Jin Hong

Byeong-Keuk Kim

Yong-Joon Lee

Seung-Jun Lee

Chul-Min Ahn

Dong-Ho Shin

Jung-Sun Kim

Young-Guk Ko

Donghoon Choi

Myeong-Ki Hong

Yangsoo Jang

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: We evaluated the effect of diabetes on the relationship between body mass index (BMI) and clinical outcomes in patients following percutaneous coronary intervention (PCI) with drug-eluting stent implantation.

Methods: A total of 6,688 patients who underwent PCI were selected from five different registries led by Korean Multicenter Angioplasty Team. They were categorized according to their BMI into the following groups: underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight to obese (≥25.0 kg/m²). Major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of death, nonfatal myocardial infarction, stroke, and target-vessel revascularization, were compared according to the BMI categories (underweight, normal and overweight to obese group) and diabetic status. All subjects completed 1-year follow-up.

Results: Among the 6,688 patients, 2,561 (38%) had diabetes. The underweight group compared to normal weight group had higher 1-year MACCE rate in both non-diabetic (adjusted hazard ratio [HR], 2.24; 95% confidence interval [CI], 1.04-4.84; p=0.039) and diabetic patients (adjusted HR, 2.86; 95% CI, 1.61-5.07; p<0.001). The overweight to obese group had a lower MACCE rate than the normal weight group in diabetic patients (adjusted HR, 0.67 [0.49-0.93]) but not in non-diabetic patients (adjusted HR, 1.06 [0.77-1.46]), with a significant interaction (p-interaction=0.025).

Conclusions: Between the underweight and normal weight groups, the association between the BMI and clinical outcomes was consistent regardless of the presence of diabetes. However, better outcomes in overweight to obese over normal weight were observed only in diabetic patients. These results suggest that the association between BMI and clinical outcomes may differ according to the diabetic status.

Citing Articles

The Obesity Paradox: An Epiphenomenon vs. A Clue for the Hidden Pathophysiology of Adiposity.

Hwang I Korean Circ J. 2023; 53(12):855-857.

PMID: 38111263 PMC: 10751181. DOI: 10.4070/kcj.2023.0278.

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