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The varying effects of obesity and morbid obesity on outcomes following cardiac transplantation
The purpose of this study was to compare the outcomes of patients undergoing cardiac transplantation stratified by body mass index (BMI, kg m − 2 ). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from...
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| Published in: | International Journal of Obesity 2016-04, Vol.40 (4), p.721-724 |
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| Main Authors: | , , , , , |
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| cites | cdi_FETCH-LOGICAL-c485t-5feab3d118f4dcfecfa57d7796eb3353b6ce129a6dbf24f3a251ec106fc33c883 |
| container_end_page | 724 |
| container_issue | 4 |
| container_start_page | 721 |
| container_title | International Journal of Obesity |
| container_volume | 40 |
| creator | Nagendran, J Moore, M D Norris, C M Khani-Hanjani, A Graham, M M Freed, D H Nagendran, J |
| description | The purpose of this study was to compare the outcomes of patients undergoing cardiac transplantation stratified by body mass index (BMI, kg m
−
2
). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from January 2004 to April 2013. All recipients were stratified by BMI into five groups (BMI: |
| doi_str_mv | 10.1038/ijo.2016.20 |
| format | article |
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−
2
). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from January 2004 to April 2013. All recipients were stratified by BMI into five groups (BMI: <20, 20–24.9, 25–29.9, 30–<34.9 and ⩾35). Patient characteristics were analyzed by analysis of variance and
χ
2
analyses. Kaplan–Meier was used to examine survival differences. Preoperative characteristics demonstrated significant increases in metabolic syndrome, prior myocardial infarction and prior coronary artery bypass graft in patients with morbid obesity. Intra-operatively, there was an increase in cardiopulmonary bypass time in patients with morbid obesity (
P
<0.01). Postoperative analysis revealed increased rates of early complications (<30 days), associated with a BMI >35. Long-term survival was also significantly decreased in patients with morbid obesity. Of interest, obesity (BMI, 30–34.9) was not associated with decreased survival. These findings suggest that, post-cardiac transplantation, patients who have a BMI ⩾35 have lower long-term survival compared with all other BMI groups. However, patients with BMI 30–34.9 did not have significantly worse outcomes and should not be excluded for heart transplantation based on BMI.</description><identifier>ISSN: 0307-0565</identifier><identifier>EISSN: 1476-5497</identifier><identifier>DOI: 10.1038/ijo.2016.20</identifier><identifier>PMID: 26853917</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/174 ; 692/308/409 ; 692/699/2743/393 ; 692/699/75 ; 692/700/139/2818 ; 692/700/565/545/576/402 ; Adult ; Alberta - epidemiology ; Analysis ; Body mass index ; Cardiovascular disease ; Cardiovascular diseases ; Coronary Disease - etiology ; Coronary Disease - mortality ; Coronary Disease - physiopathology ; Epidemiology ; Female ; Health Promotion and Disease Prevention ; Heart transplantation ; Heart Transplantation - mortality ; Humans ; Internal Medicine ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Metabolic disorders ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Myocardial Infarction - physiopathology ; Obesity ; Obesity, Morbid - complications ; Obesity, Morbid - mortality ; Obesity, Morbid - physiopathology ; Patient outcomes ; Patient Selection ; Postoperative Complications - etiology ; Proportional Hazards Models ; Public Health ; Risk Assessment ; Risk Factors ; short-communication ; Survival ; Transplantation ; Treatment Outcome ; Variance analysis</subject><ispartof>International Journal of Obesity, 2016-04, Vol.40 (4), p.721-724</ispartof><rights>Macmillan Publishers Limited 2016</rights><rights>COPYRIGHT 2016 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Apr 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-5feab3d118f4dcfecfa57d7796eb3353b6ce129a6dbf24f3a251ec106fc33c883</citedby><cites>FETCH-LOGICAL-c485t-5feab3d118f4dcfecfa57d7796eb3353b6ce129a6dbf24f3a251ec106fc33c883</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26853917$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nagendran, J</creatorcontrib><creatorcontrib>Moore, M D</creatorcontrib><creatorcontrib>Norris, C M</creatorcontrib><creatorcontrib>Khani-Hanjani, A</creatorcontrib><creatorcontrib>Graham, M M</creatorcontrib><creatorcontrib>Freed, D H</creatorcontrib><creatorcontrib>Nagendran, J</creatorcontrib><title>The varying effects of obesity and morbid obesity on outcomes following cardiac transplantation</title><title>International Journal of Obesity</title><addtitle>Int J Obes</addtitle><addtitle>Int J Obes (Lond)</addtitle><description>The purpose of this study was to compare the outcomes of patients undergoing cardiac transplantation stratified by body mass index (BMI, kg m
−
2
). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from January 2004 to April 2013. All recipients were stratified by BMI into five groups (BMI: <20, 20–24.9, 25–29.9, 30–<34.9 and ⩾35). Patient characteristics were analyzed by analysis of variance and
χ
2
analyses. Kaplan–Meier was used to examine survival differences. Preoperative characteristics demonstrated significant increases in metabolic syndrome, prior myocardial infarction and prior coronary artery bypass graft in patients with morbid obesity. Intra-operatively, there was an increase in cardiopulmonary bypass time in patients with morbid obesity (
P
<0.01). Postoperative analysis revealed increased rates of early complications (<30 days), associated with a BMI >35. Long-term survival was also significantly decreased in patients with morbid obesity. Of interest, obesity (BMI, 30–34.9) was not associated with decreased survival. These findings suggest that, post-cardiac transplantation, patients who have a BMI ⩾35 have lower long-term survival compared with all other BMI groups. However, patients with BMI 30–34.9 did not have significantly worse outcomes and should not be excluded for heart transplantation based on BMI.</description><subject>692/308/174</subject><subject>692/308/409</subject><subject>692/699/2743/393</subject><subject>692/699/75</subject><subject>692/700/139/2818</subject><subject>692/700/565/545/576/402</subject><subject>Adult</subject><subject>Alberta - epidemiology</subject><subject>Analysis</subject><subject>Body mass index</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Coronary Disease - etiology</subject><subject>Coronary Disease - mortality</subject><subject>Coronary Disease - physiopathology</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health Promotion and Disease Prevention</subject><subject>Heart transplantation</subject><subject>Heart Transplantation - mortality</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Metabolic disorders</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Obesity</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - mortality</subject><subject>Obesity, Morbid - physiopathology</subject><subject>Patient outcomes</subject><subject>Patient Selection</subject><subject>Postoperative Complications - etiology</subject><subject>Proportional Hazards Models</subject><subject>Public Health</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>short-communication</subject><subject>Survival</subject><subject>Transplantation</subject><subject>Treatment Outcome</subject><subject>Variance analysis</subject><issn>0307-0565</issn><issn>1476-5497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNktFrFDEQxoMo9qw--S4BoQh1z2Sz2ew-lqJVKPSlPodsMrnLsZucSVbpf98sV2srfSiBCUx-8zEz-RB6T8maEtZ9cbuwrgltS3iBVrQRbcWbXrxEK8KIqAhv-RF6k9KOEMI5qV-jo7rtOOupWCF5vQX8W8Ub5zcYrAWdEw4WhwGSyzdYeYOnEAdn7lPB4zBnHSZI2IZxDH-WWq2icUrjHJVP-1H5rLIL_i16ZdWY4N3dfYx-fvt6ff69ury6-HF-dlnppuO54hbUwAylnW2MLl1YxYURom9hYIyzodVA6161ZrB1Y5mqOQVNSWs1Y7rr2DH6dNDdx_BrhpTl5JKGsTQCYU6Sio7wmgrWPwMVPSloxwr68T90F-boyyAL1TVlob34R23UCNJ5G8oS9CIqzxpO-4aIeulw_QRVjoHJ6eDBupJ_VHDyoGALaszbFMZ5WWt6DJ4eQB1DShGs3Ec3lT-VlMjFIrJYRC4WKaHQH-5mmocJzD371xMF-HwAUnnyG4gPhn5C7xZ-aMQh</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Nagendran, J</creator><creator>Moore, M D</creator><creator>Norris, C M</creator><creator>Khani-Hanjani, A</creator><creator>Graham, M M</creator><creator>Freed, D H</creator><creator>Nagendran, J</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7TK</scope><scope>7TS</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U2</scope></search><sort><creationdate>20160401</creationdate><title>The varying effects of obesity and morbid obesity on outcomes following cardiac transplantation</title><author>Nagendran, J ; Moore, M D ; Norris, C M ; Khani-Hanjani, A ; Graham, M M ; Freed, D H ; Nagendran, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-5feab3d118f4dcfecfa57d7796eb3353b6ce129a6dbf24f3a251ec106fc33c883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>692/308/174</topic><topic>692/308/409</topic><topic>692/699/2743/393</topic><topic>692/699/75</topic><topic>692/700/139/2818</topic><topic>692/700/565/545/576/402</topic><topic>Adult</topic><topic>Alberta - 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Academic</collection><collection>Safety Science and Risk</collection><jtitle>International Journal of Obesity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nagendran, J</au><au>Moore, M D</au><au>Norris, C M</au><au>Khani-Hanjani, A</au><au>Graham, M M</au><au>Freed, D H</au><au>Nagendran, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The varying effects of obesity and morbid obesity on outcomes following cardiac transplantation</atitle><jtitle>International Journal of Obesity</jtitle><stitle>Int J Obes</stitle><addtitle>Int J Obes (Lond)</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>40</volume><issue>4</issue><spage>721</spage><epage>724</epage><pages>721-724</pages><issn>0307-0565</issn><eissn>1476-5497</eissn><abstract>The purpose of this study was to compare the outcomes of patients undergoing cardiac transplantation stratified by body mass index (BMI, kg m
−
2
). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from January 2004 to April 2013. All recipients were stratified by BMI into five groups (BMI: <20, 20–24.9, 25–29.9, 30–<34.9 and ⩾35). Patient characteristics were analyzed by analysis of variance and
χ
2
analyses. Kaplan–Meier was used to examine survival differences. Preoperative characteristics demonstrated significant increases in metabolic syndrome, prior myocardial infarction and prior coronary artery bypass graft in patients with morbid obesity. Intra-operatively, there was an increase in cardiopulmonary bypass time in patients with morbid obesity (
P
<0.01). Postoperative analysis revealed increased rates of early complications (<30 days), associated with a BMI >35. Long-term survival was also significantly decreased in patients with morbid obesity. Of interest, obesity (BMI, 30–34.9) was not associated with decreased survival. These findings suggest that, post-cardiac transplantation, patients who have a BMI ⩾35 have lower long-term survival compared with all other BMI groups. However, patients with BMI 30–34.9 did not have significantly worse outcomes and should not be excluded for heart transplantation based on BMI.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>26853917</pmid><doi>10.1038/ijo.2016.20</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0307-0565 |
| ispartof | International Journal of Obesity, 2016-04, Vol.40 (4), p.721-724 |
| issn | 0307-0565 1476-5497 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1780521739 |
| source | Springer Nature; Nature |
| subjects | 692/308/174 692/308/409 692/699/2743/393 692/699/75 692/700/139/2818 692/700/565/545/576/402 Adult Alberta - epidemiology Analysis Body mass index Cardiovascular disease Cardiovascular diseases Coronary Disease - etiology Coronary Disease - mortality Coronary Disease - physiopathology Epidemiology Female Health Promotion and Disease Prevention Heart transplantation Heart Transplantation - mortality Humans Internal Medicine Kaplan-Meier Estimate Male Medicine Medicine & Public Health Metabolic Diseases Metabolic disorders Middle Aged Mortality Myocardial infarction Myocardial Infarction - etiology Myocardial Infarction - mortality Myocardial Infarction - physiopathology Obesity Obesity, Morbid - complications Obesity, Morbid - mortality Obesity, Morbid - physiopathology Patient outcomes Patient Selection Postoperative Complications - etiology Proportional Hazards Models Public Health Risk Assessment Risk Factors short-communication Survival Transplantation Treatment Outcome Variance analysis |
| title | The varying effects of obesity and morbid obesity on outcomes following cardiac transplantation |
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