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Cheng JF, Lee CL, Chiang JY, Liu SC, Huang CH, Liou JT, Chang CJ, Tsai CT, Tsai CT, Wang YC, Hwang JJ. Impact of aging on long-term cardiac outcomes of true-lumen recanalized chronic total occlusions in patients with overweight/obesity. Int J Obes (Lond) 2024:10.1038/s41366-024-01623-2. [PMID: 39232101 DOI: 10.1038/s41366-024-01623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 08/17/2024] [Accepted: 08/21/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Obesity paradox addressing all-cause mortality has been described in several chronic total occlusion (CTO) studies. However, the impact of aging on long-term cardiac events in patients with overweight and obesity with CTO recanalization were less studied. METHODS A total of 458 patients (64.4 ± 11.3 years, 403 male) with CTO interventions were enrolled. The overweight/obesity group included 311 patients with body mass index (BMI) ≧24 kg/m2 and the non-obesity group included 147. With a median follow-up of 40.0 (17.9-61.4) months, 422 patients with successful true-lumen recanalization were further assessed for target lesion failure [TLF: cardiac death, target vessel myocardial infarction (TVMI), target lesion revascularization (TLR)]. RESULTS At follow-up, the rates of cardiac death, TVMI, TLR, TLF, and stent thrombosis were 1.9%, 1.9%, 9.2%, 10.7%, and 0.5%, respectively. The TVMI-free survival was borderline better (p = 0.067 by log-rank test) in overweight/obesity than non-obesity group. Among patients <65 years of age, the TVMI-free survival was significantly better in the overweight/obesity group (p = 0.013 compared to non-obesity group by log-rank test). In multivariate Cox regression model, the non-obesity patients younger than 65 years were at a higher risk of TVMI, not only among those <65 years of age (hazard ratio = 11.0, 95% CI = 1.1-106.0) but also among the whole patients (hazard ratio=6.9, 95% CI = 1.4-35.1) with successful CTO recanalization. CONCLUSIONS For those with true-lumen recanalized CTO, the higher risk of TVMI after successful recanalization was rather evident in patients <65 years of age and without overweight/obesity, suggesting that aging might attenuate prognostic significance of "obesity paradox" for CTO interventions.
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Affiliation(s)
- Jen-Fang Cheng
- Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Lin Lee
- Cardiovascular Division, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jiunn-Yang Chiang
- Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Chi Liu
- Cardiovascular Division, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Chi-Hung Huang
- Cardiovascular Division, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
| | - Jun-Ting Liou
- Cardiovascular Division, Department of Internal Medicine, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chi-Jen Chang
- Cardiovascular Division, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Cheng-Ting Tsai
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chia-Ti Tsai
- Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chih Wang
- Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Juey-Jen Hwang
- Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Cardiovascular Division, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
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Gupta R, Sharma KK, Khedar RS, Sharma SK, Makkar JS, Bana A, Natani V, Bharati S, Kumar S, Hadiya V, Lodha S, Sharma SK. Low body mass index is associated with adverse cardiovascular outcomes following PCI in India: ACC-NCDR registry. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200230. [PMID: 38192277 PMCID: PMC10772713 DOI: 10.1016/j.ijcrp.2023.200230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/24/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
Objective Registry-based prospective study was conducted to evaluate association of body mass index (BMI) with major adverse coronary events (MACE) following percutaneous coronary intervention (PCI). Methods Successive patients undergoing PCI were enrolled from April'19 to March'22 and classified into five BMI categories (<23.0,23.0-24.9,25.0-26.9,27.0-29.9, and ≥30.0 kg/m2). Clinical, angiographic features, interventions and outcomes were obtained by in-person or telephonic follow-up. Primary endpoints were (a) MACE(cardiovascular deaths, acute coronary syndrome or stroke, revascularization, hospitalization and all-cause deaths) and (b)cardiovascular deaths. Cox-proportionate hazard ratios(HR) and 95 % confidence intervals(CI) were calculated. Results The cohort included 4045 patients. Mean age was 60.3 ± 11y, 3233(79.7 %) were men. There was high prevalence of cardiometabolic risk factors. 90 % patients had acute coronary syndrome(STEMI 39.6 %, NSTEMI/unstable angina 60.3 %), 60.0 % had impaired ejection fraction(EF) and multivessel CAD. Lower BMI groups (<23.0 kg/m2) had higher prevalence of tobacco use, reduced ejection fraction(EF), multivessel CAD, stents, and less primary PCI for STEMI. There was no difference in discharge medications and in-hospital deaths. Median follow-up was 24 months (IQR 12-36), available in 3602(89.0 %). In increasing BMI categories, respectively, MACE was in 10.9,8.9,9.5,9.1 and 6.8 % (R2 = 0.73) and CVD deaths in 5.1,4.5,4.4,5.1 and 3.5 % (R2 = 0.39). Compared to lowest BMI category, age-sex adjusted HR in successive groups for MACE were 0.89,0.87,0.79,0.69 and CVD deaths 0.98,0.87,0.95,0.75 with overlapping CI. HR attenuated following multivariate adjustments. Conclusions Low BMI patients have higher incidence of major adverse cardiovascular events following PCI in India. These patients are older, with greater tobacco use, lower EF, multivessel CAD, delayed STEMI-PCI, and longer hospitalization.
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Affiliation(s)
- Rajeev Gupta
- Department of Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Krishna Kumar Sharma
- Department of Clinical Research, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
- Department of Pharmacology, LBS College of Pharmacy, Rajasthan University of Health Sciences, Jaipu, 302004, India
| | - Raghubir Singh Khedar
- Department of Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Sanjeev Kumar Sharma
- Department of Cardiology, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Jitender Singh Makkar
- Department of Cardiology, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Ajeet Bana
- Department of Cardiovascular Surgery, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Vishnu Natani
- Department of Clinical Research, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Shilpa Bharati
- Department of Clinical Research, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Sumit Kumar
- Department of Clinical Research, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Vishal Hadiya
- Department of Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Sailesh Lodha
- Departments of Endocrinology, Eternal Heart Care Centre & Research Institute, Jaipur, 302017, India
| | - Samin Kumar Sharma
- Department of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
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Rao C, Zhong Q, Wu R, Li Z, Duan Y, Zhou Y, Wang C, Chen X, Wang R, He K. Impact of body mass index on long-term outcomes in patients undergoing percutaneous coronary intervention stratified by diabetes mellitus: a retrospective cohort study. BMC Cardiovasc Disord 2024; 24:113. [PMID: 38365597 PMCID: PMC10874050 DOI: 10.1186/s12872-024-03770-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Patients with diabetes mellitus (DM) caused by obesity have increased in recent years. The impact of obesity on long-term outcomes in patients undergoing percutaneous coronary intervention (PCI) with or without DM remains unclear. METHODS We retrospectively analysed data from 1918 patients who underwent PCI. Patients were categorized into four groups based on body mass index (BMI, normal weight: BMI < 25 kg/m2; overweight and obese: BMI ≥ 25 kg/m2) and DM status (presence or absence). The primary endpoint was the occurrence of major adverse cardiac and cerebrovascular events (MACCE; defined as all-cause death, myocardial infarction, stroke, and unplanned repeat revascularization). RESULTS During a median follow-up of 7.0 years, no significant differences in MACCE, myocardial infarction, or stroke were observed among the four groups. Overweight and obese individuals exhibited lower all-cause mortality rates compared with normal-weight patients (without DM: hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.37 to 0.78; with DM: HR: 0.57, 95% CI: 0.38 to 0.86). In non-diabetic patients, the overweight and obese group demonstrated a higher risk of unplanned repeat revascularization than the normal-weight group (HR:1.23, 95% CI:1.03 to 1.46). After multivariable adjustment, overweight and obesity were not significantly associated with MACCE, all-cause death, myocardial infarction, stroke, or unplanned repeat revascularization in patients with and without diabetes undergoing PCI. CONCLUSION Overweight and obesity did not demonstrate a significant protective effect on long-term outcomes in patients with and without diabetes undergoing PCI.
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Affiliation(s)
- Chongyou Rao
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
- Graduate School of Chinese, PLA General Hospital, Beijing, 100853, China
| | - Qin Zhong
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
- Graduate School of Chinese, PLA General Hospital, Beijing, 100853, China
| | - Rilige Wu
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
| | - Zongren Li
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
| | - Yongjie Duan
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
| | - You Zhou
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Chi Wang
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
| | - Xu Chen
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
| | - Ruiqing Wang
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China
| | - Kunlun He
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese, PLA General Hospital, 28 Fuxing RD, Beijing, 100853, China.
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Mei X, Hu S, Mi L, Zhou Y, Chen T. Body mass index and all-cause mortality in patients with percutaneous coronary intervention: A dose-response meta-analysis of obesity paradox. Obes Rev 2021; 22:e13107. [PMID: 32686338 DOI: 10.1111/obr.13107] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 12/20/2022]
Abstract
The association between body mass index (BMI) and mortality of patients with percutaneous coronary intervention (PCI) is still controversial. We hope to explore whether the 'obesity paradox' really exists through this dose-response meta-analysis. PubMed, Embase and Cochrane databases were systematically searched for eligible studies up to April 2020. The random-effects restricted cubic spline models were used to evaluate the potential non-linear relationship between BMI and all-cause mortality of patients undergoing PCI. Fifteen studies were identified and included total 138 592 participants. The pooled hazard ratio of all-cause mortality was 0.60 (95% confidence interval: 0.45-0.82) when compared the highest category (mean = 33.32 kg m-2 ) of BMI with the lowest category (mean = 18.89 kg m-2 ). A non-linear U-shaped dose-response curve between BMI and the risk of all-cause mortality was found, with higher mortality rate at BMI lower than 27 kg m-2 and higher than 32 kg m-2 . The 'obesity paradox' does exist after PCI. The association between BMI and the risk of all-cause mortality for patients undergoing PCI is U shaped, with a nadir of risk at a BMI of 27 to 32 kg m-2 and the highest risk at patients with underweight. The relationship between other prognostic indicators and BMI is worthy of further research.
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Affiliation(s)
- Xiaofei Mei
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shengda Hu
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lijie Mi
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yafeng Zhou
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Tan Chen
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Ratwatte S, Hyun K, D'Souza M, Barraclough J, Chew DP, Shetty P, Patel S, Amos D, Brieger D. Relation of Body Mass Index to Outcomes in Acute Coronary Syndrome. Am J Cardiol 2021; 138:11-19. [PMID: 33058799 DOI: 10.1016/j.amjcard.2020.09.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/24/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022]
Abstract
We assessed the association of BMI with all-cause and cardiovascular (CV) mortality in a contemporary acute coronary syndrome cohort. Patients from the Australian Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events and Global Registry of Acute Coronary Events between 2009 and 2019, were divided into BMI subgroups (underweight: <18.5, healthy: 18.5 to 24.9, overweight: 25 to 29.9, obese: 30 to 39.9, extremely obese: >40). Logistic regression was used to determine the association between BMI group and outcomes of all cause and CV death in hospital, and at 6 months. 8,503 patients were identified, mean age 64 ± 13, 72% male. The BMI breakdown was: underweight- 95, healthy- 2,140, overweight- 3,258, obese- 2,653, extremely obese- 357. Obese patients were younger (66 ± 12 vs 67 ± 13), with more hypertension, diabetes, and dyslipidemia vs healthy (all p < 0.05). Obese had lower hospital mortality than healthy: all-cause: 1% versus 4%, aOR (95% CI): 0.49(0.27, 0.87); CV: 1% versus 3%, 0.51(0.27, 0.96). At 6-month underweight had higher mortality than healthy: all-cause: 11% versus 4%, 2.69(1.26, 5.76); CV: 7% versus 1%, 3.54(1.19, 10.54); whereas obese had lower mortality: all-cause: 1% versus 4%, 0.48(0.29, 0.77); CV: 0.4% versus 1%, 0.42(0.19, 0.93). When BMI was plotted as a continuous variable against outcome a U-shaped relationship was demonstrated, with highest event rates in the most obese (>60). In conclusion, BMI is associated with mortality following an acute coronary syndrome. Obese patients had the best outcomes, suggesting persistence of the obesity paradox. However, there was a threshold effect, and favorable outcomes did not extend to the most obese.
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Affiliation(s)
- Seshika Ratwatte
- Department of Cardiology, Concord Repatriation General Hospital, Concord, Australia
| | - Karice Hyun
- ANZAC Research Institute, NSW, Australia; Westmead Applied Research Centre, University of Sydney, NSW, Australia
| | - Mario D'Souza
- University of Sydney, NSW, Australia; Clinical Research Centre, Sydney Local Health District, NSW, Australia
| | | | - Derek P Chew
- Department of Cardiology, Flinders University, Australia
| | - Pratap Shetty
- Department of Cardiology Wollongong Hospital, NSW, Australia
| | - Sanjay Patel
- Department of Cardiology Royal Prince Alfred Hospital, NSW, Australia
| | - David Amos
- Department of Cardiology, Orange Base Hospital, NSW, Australia
| | - David Brieger
- Department of Cardiology, Concord Repatriation General Hospital, Concord, Australia.
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Sun D, Zhang Q, Li W, Wang H. Body Mass Index and 1-Year Unplanned Readmission in Chinese Patients with Acute Myocardial Infarction: A Retrospective Cohort Study. Cardiol Res Pract 2020; 2020:4158209. [PMID: 32148951 PMCID: PMC7049439 DOI: 10.1155/2020/4158209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/16/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence regarding the relationship between body mass index (BMI) and 1-year unplanned readmission was limited. Therefore, the objective of this research is to investigate whether BMI was independently related to 1-year unplanned readmission in Chinese patients with acute myocardial infarction (AMI) after percutaneous transluminal coronary intervention (PCI) after adjusting for other covariates. METHODS The present study was a cohort study. A total of 214 participants with AMI after PCI were involved in a hospital in China from 1st January 2017 to 1st January 2018. The target independent variable and the dependent variable were BMI measured at baseline and 1-year unplanned readmission, respectively. Covariates involved in this study included age, gender, TC, triglyceride, HDL-C, LDL-C, PT, APTT, INR, creatinine, HGB, LVEF, discharge medication, marital status, educational level, COPD, diabetes mellitus, heart failure, history of ischemic stroke, history of hemorrhagic stroke, arrhythmia, and hypertension. RESULTS The average age of 172 selected participants was 60.2 ± 10.8 years old, and about 68.6% of them was male. The rate of readmission in patients with AMI was 26.14%. The result of fully adjusted binary logistic regression showed BMI was negatively associated with risk of readmission after adjusting confounders (hazard ratio (HR) = 1.1, 95% CI 0.93-1.29). Nonlinear relationship was detected between BMI and 1-year unplanned readmission, whose point was 29.3. The effect sizes and the confidence intervals of the left and right sides of inflection point were 0.9 (0.7-1.2, P for nonlinearity = 0.530) and 2.8 (1.3-5.8, P for nonlinearity = 0.530) and 2.8 (1.3-5.8. CONCLUSION BMI has a nonlinear relationship with 1-year unplanned readmission in patients with myocardial infarction. The 1-year unplanned readmission rate of overweight patients (BMI > 29.3 kg/m2) has increased significantly. Obesity paradox does not exist in terms of readmission of Chinese patients with myocardial infarction after PCI.
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Affiliation(s)
- Dandan Sun
- Department of Cardiology of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng District, Jining 272000, Shandong Province, China
| | - Qingyun Zhang
- Department of Cardiology of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng District, Jining 272000, Shandong Province, China
| | - Wei Li
- Nursing Department of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng District, Jining 272000, Shandong Province, China
| | - Haichen Wang
- Office of Party Committee of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng District, Jining 272000, Shandong Province, China
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Hatani Y, Tanaka H, Mochizuki Y, Suto M, Yokota S, Mukai J, Takada H, Soga F, Hatazawa K, Matsuzoe H, Matsumoto K, Hirota Y, Ogawa W, Hirata KI. Association of body fat mass with left ventricular longitudinal myocardial systolic function in type 2 diabetes mellitus. J Cardiol 2020; 75:189-195. [DOI: 10.1016/j.jjcc.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
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Sarcopenia in adults with congenital heart disease: Nutritional status, dietary intake, and resistance training. J Cardiol 2019; 74:84-89. [DOI: 10.1016/j.jjcc.2019.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/22/2018] [Accepted: 01/18/2019] [Indexed: 12/30/2022]
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Wada H, Dohi T, Miyauchi K, Shitara J, Endo H, Doi S, Tsuboi S, Ogita M, Iwata H, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H. Mean platelet volume and long-term cardiovascular outcomes in patients with stable coronary artery disease. Atherosclerosis 2018; 277:108-112. [PMID: 30195145 DOI: 10.1016/j.atherosclerosis.2018.08.048] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/31/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Although an elevated mean platelet volume (MPV) has been associated with poor clinical outcomes after acute coronary syndrome (ACS), the association between MPV and long-term outcomes in patients with stable coronary artery disease (CAD) remains uncertain. We aimed to investigate the impact of pre-procedural MPV levels in patients following elective percutaneous coronary intervention (PCI). METHODS We studied 2872 stable CAD patients who underwent their first PCI and who had available data on pre-procedural MPV between 2002 and 2016. Patients were divided into quartiles based on their MPV. The incidences of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, were evaluated. RESULTS The median MPV was 10.4 fL (interquartile range: 9.8-11.0). During a median follow-up of 5.6 years, 498 (17.3%) MACE were identified, with a cumulative incidence significantly higher in the lowest MPV group than in other groups (p < 0.01). After adjustment for platelet count and the other cardiovascular risk factors, the lowest MPV group had a significantly higher risk of MACE compared with the highest MPV groups (hazard ratio: 1.43, 95% confidence interval 1.10-1.86, p = 0.009). Decreasing MPV as a continuous variable was associated with the incidence of MACE (hazard ratio: 1.16 per 1 fL decrease, 95% confidence interval 1.04-1.30, p = 0.007). CONCLUSIONS Contrary to previous studies on ACS patients, this study showed that a low MPV was associated with worse clinical outcomes among stable CAD patients.
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Affiliation(s)
- Hideki Wada
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Tomotaka Dohi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jun Shitara
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirohisa Endo
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinichiro Doi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shuta Tsuboi
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Manabu Ogita
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Hiroshi Iwata
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinya Okazaki
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kikuo Isoda
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satoru Suwa
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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