Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization

Objectives. The purpose of this study was to determine whether there is a dose-response relationship between body mass index (BMI) and all-cause mortality in patients after coronary revascularization. Methods. The MIMIC-III database (version 1.4) was used as the sample population. For variables with...

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Main Authors: Chengzhuo Li, Didi Han, Fengshuo Xu, Shuai Zheng, Luming Zhang, Zichen Wang, Rui Yang, Haiyan Yin, Jun Lyu
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2021/3867735
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author Chengzhuo Li
Didi Han
Fengshuo Xu
Shuai Zheng
Luming Zhang
Zichen Wang
Rui Yang
Haiyan Yin
Jun Lyu
author_facet Chengzhuo Li
Didi Han
Fengshuo Xu
Shuai Zheng
Luming Zhang
Zichen Wang
Rui Yang
Haiyan Yin
Jun Lyu
author_sort Chengzhuo Li
collection DOAJ
description Objectives. The purpose of this study was to determine whether there is a dose-response relationship between body mass index (BMI) and all-cause mortality in patients after coronary revascularization. Methods. The MIMIC-III database (version 1.4) was used as the sample population. For variables with less than 10% of values missing, we used the mice package of R software for multiple imputations. Cox regression was used to determine the risk factors of all-cause mortality in patients. RCSs were used to observe the relationship between BMI and all-cause mortality. Additional subgroup and sensitivity analyses were also performed to explore whether the conclusion can be applied to specific groups. Results. Both univariate and multivariate Cox models indicated that the mortality risk was lower for overweight patients than for normal-weight patients (P<0.05). In RCS models, BMI had a U-shaped relationship with all-cause mortality of patients after coronary artery bypass grafting (CABG) (P for nonlinearity = 0.0028). There was a weak U-shaped relationship between BMI and all-cause mortality after percutaneous coronary intervention (PCI), but the nonlinear relationship between these two parameters was not significant (P for nonlinearity = 0.1756). Conclusions. The obesity paradox does exist in patients treated with CABG and PCI. RCS analysis indicated that there was a U-shaped relationship between BMI and all-cause mortality in patients after CABG. After sex stratification, the relationship between BMI and all-cause mortality in male patients who received PCI was L-shaped, while the nonlinear relationship among females was not significant.
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spelling doaj-art-15f0cab4c24c4cd596302175397a6f082025-08-20T02:02:43ZengWileyJournal of Interventional Cardiology1540-81832021-01-01202110.1155/2021/3867735Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary RevascularizationChengzhuo Li0Didi Han1Fengshuo Xu2Shuai Zheng3Luming Zhang4Zichen Wang5Rui Yang6Haiyan Yin7Jun Lyu8Intensive Care UnitIntensive Care UnitIntensive Care UnitIntensive Care UnitIntensive Care UnitDepartment of Public HealthIntensive Care UnitIntensive Care UnitIntensive Care UnitObjectives. The purpose of this study was to determine whether there is a dose-response relationship between body mass index (BMI) and all-cause mortality in patients after coronary revascularization. Methods. The MIMIC-III database (version 1.4) was used as the sample population. For variables with less than 10% of values missing, we used the mice package of R software for multiple imputations. Cox regression was used to determine the risk factors of all-cause mortality in patients. RCSs were used to observe the relationship between BMI and all-cause mortality. Additional subgroup and sensitivity analyses were also performed to explore whether the conclusion can be applied to specific groups. Results. Both univariate and multivariate Cox models indicated that the mortality risk was lower for overweight patients than for normal-weight patients (P<0.05). In RCS models, BMI had a U-shaped relationship with all-cause mortality of patients after coronary artery bypass grafting (CABG) (P for nonlinearity = 0.0028). There was a weak U-shaped relationship between BMI and all-cause mortality after percutaneous coronary intervention (PCI), but the nonlinear relationship between these two parameters was not significant (P for nonlinearity = 0.1756). Conclusions. The obesity paradox does exist in patients treated with CABG and PCI. RCS analysis indicated that there was a U-shaped relationship between BMI and all-cause mortality in patients after CABG. After sex stratification, the relationship between BMI and all-cause mortality in male patients who received PCI was L-shaped, while the nonlinear relationship among females was not significant.http://dx.doi.org/10.1155/2021/3867735
spellingShingle Chengzhuo Li
Didi Han
Fengshuo Xu
Shuai Zheng
Luming Zhang
Zichen Wang
Rui Yang
Haiyan Yin
Jun Lyu
Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
Journal of Interventional Cardiology
title Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
title_full Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
title_fullStr Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
title_full_unstemmed Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
title_short Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
title_sort obesity paradox of all cause mortality in 4 133 patients treated with coronary revascularization
url http://dx.doi.org/10.1155/2021/3867735
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