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Relation of Body Mass Index to Late Survival After Valvular Heart Surgery

Limited data have suggested that an “obesity paradox” exists for mortality and cardiovascular outcomes in patients undergoing coronary artery bypass grafting. Much less is known about the role of the preoperative body mass index (BMI) in patients undergoing valve surgery. We evaluated 2,640 consecut...

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Published in:The American journal of cardiology 2012-12, Vol.110 (11), p.1667-1678
Main Authors: Vaduganathan, Muthiah, MD, MPH, Lee, Richard, MD, MBA, Beckham, Allison J., BS, Andrei, Adin-Cristian, PhD, Lapin, Brittany, MPH, Stone, Neil J., MD, McGee, Edwin C., MD, Malaisrie, S. Chris, MD, Kansal, Preeti, MD, Silverberg, Robert A., MD, Lloyd-Jones, Donald M., MD, ScM, McCarthy, Patrick M., MD
Format: Article
Language:English
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Summary:Limited data have suggested that an “obesity paradox” exists for mortality and cardiovascular outcomes in patients undergoing coronary artery bypass grafting. Much less is known about the role of the preoperative body mass index (BMI) in patients undergoing valve surgery. We evaluated 2,640 consecutive patients who underwent valve surgery between April 2004 and March 2011. The patients were classified by the World Health Organization standards as “underweight” (BMI 11.5 to 18.4 kg/m2 , n = 61), “normal weight” (BMI 18.5 to 24.9 kg/m2 , n = 865), “overweight” (BMI 25 to 29.9 kg/m2 , n = 1,020), and “obese” (BMI 30 to 60.5 kg/m2 , n = 694). Mortality was ascertained using the Social Security Death Index. Hazard ratios (HRs), adjusted for known preoperative risk factors, were obtained using Cox regression models. The mean follow-up was 31.9 ± 20.5 months. The long-term mortality rate was 1.21, 0.52, 0.32, and 0.44 per 10 years of person-time for underweight, normal, overweight, and obese patients, respectively. Compared to the normal BMI category, overweight patients (adjusted HR 0.60, 95% confidence interval 0.46 to 0.79, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2012.07.041