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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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Autores principales: Li, Chengzhuo, Han, Didi, Xu, Fengshuo, Zheng, Shuai, Zhang, Luming, Wang, Zichen, Yang, Rui, Yin, Haiyan, Lyu, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616700/
https://www.ncbi.nlm.nih.gov/pubmed/34887705
http://dx.doi.org/10.1155/2021/3867735
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author Li, Chengzhuo
Han, Didi
Xu, Fengshuo
Zheng, Shuai
Zhang, Luming
Wang, Zichen
Yang, Rui
Yin, Haiyan
Lyu, Jun
author_facet Li, Chengzhuo
Han, Didi
Xu, Fengshuo
Zheng, Shuai
Zhang, Luming
Wang, Zichen
Yang, Rui
Yin, Haiyan
Lyu, Jun
author_sort Li, Chengzhuo
collection PubMed
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 pubmed-86167002021-12-08 Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization Li, Chengzhuo Han, Didi Xu, Fengshuo Zheng, Shuai Zhang, Luming Wang, Zichen Yang, Rui Yin, Haiyan Lyu, Jun J Interv Cardiol Research Article 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. Hindawi 2021-11-18 /pmc/articles/PMC8616700/ /pubmed/34887705 http://dx.doi.org/10.1155/2021/3867735 Text en Copyright © 2021 Chengzhuo Li et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Li, Chengzhuo
Han, Didi
Xu, Fengshuo
Zheng, Shuai
Zhang, Luming
Wang, Zichen
Yang, Rui
Yin, Haiyan
Lyu, Jun
Obesity Paradox of All-Cause Mortality in 4,133 Patients Treated with Coronary Revascularization
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616700/
https://www.ncbi.nlm.nih.gov/pubmed/34887705
http://dx.doi.org/10.1155/2021/3867735
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