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Underweight and obesity are related to higher mortality in patients undergoing coronary angiography: The KARDIO invasive cardiology register study.

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posted on 2023-12-05, 14:44 authored by Jari A Laukkanen, Setor K Kunutsor, Jussi Hernesniemi, Jaakko Immonen, Markku Eskola, Francesco Zaccardi, Matti Niemelä, Timo Mäkikallio, Magnus Hagnäs, Jarkko Piuhola, Jukka Juvonen, Jussi Sia, Juha Rummukainen, Kari Kervinen, Juha Karvanen, Kjell Nikus, KARDIO Study Group

Background

In patients with some cardiovascular disease conditions, slightly elevated body mass index (BMI) is associated with a lower mortality risk (termed "obesity paradox"). It is uncertain, however, if this obesity paradox exists in patients who have had invasive cardiology procedures. We evaluated the association between BMI and mortality in patients who underwent coronary angiography.

Methods

We utilised the KARDIO registry, which comprised data on demographics, prevalent diseases, risk factors, coronary angiographies, and interventions on 42,636 patients. BMI was categorised based on WHO cut-offs or transformed using P-splines. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for all-cause mortality.

Results

During a median follow-up of 4.9 years, 4688 all-cause deaths occurred. BMI was nonlinearly associated with mortality risk: compared to normal weight category (18.5-25 kg/m2 ), the age-adjusted HRs (95% CIs) for all-cause mortality were 1.90 (1.49, 2.43), 0.96 (0.92, 1.01), 1.04 (0.99, 1.09), 1.08 (0.96, 1.20), and 1.45 (1.22, 1.72) for underweight (<18.5 kg/m2 ), preobesity (25 to <30 kg/m2 ), obesity class I (30 to <35 kg/m2 ), obesity class II (35 to <40 kg/m2 ), and obesity class III (>40 kg/m2 ), respectively. The corresponding multivariable adjusted HRs (95% CIs) were 2.00 (1.55, 2.58), 0.92 (0.88, 0.97) 1.01 (0.95, 1.06), 1.10 (0.98, 1.23), and 1.49 (1.26, 1,78), respectively.

Conclusions

In patients undergoing coronary angiography, underweight and obesity class III are associated with increased mortality risk, and the lowest mortality was observed in the preobesity class. It appears the obesity paradox may be present in patients who undergo invasive coronary procedures.

History

Citation

Laukkanen, JA, Kunutsor, SK, Hernesniemi, J, et al. Underweight and obesity are related to higher mortality in patients undergoing coronary angiography: the KARDIO invasive cardiology register study. Catheter Cardiovasc Interv. 2022; 100: 1242-1251. doi:10.1002/ccd.30463

Version

  • VoR (Version of Record)

Published in

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

Volume

100

Issue

7

Pagination

1242-1251

Publisher

Wiley

issn

1522-1946

eissn

1522-726X

Acceptance date

2022-10-17

Copyright date

2022

Available date

2023-12-05

Spatial coverage

United States

Language

eng

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