KMID : 0368120210510080696
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Korean Circulation Journal 2021 Volume.51 No. 8 p.696 ~ p.707
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Association between Body Mass Index and Clinical Outcomes of Peripheral Artery Disease after Endovascular Therapy: Data from K-VIS ELLA Registry
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Lim Che-Wan
Won Ho-Youn Ko Young-Guk Lee Seung-Jun Ahn Chul-Min Min Pil-Ki Lee Jae-Hwan Yoon Chang-Hwan Yu Cheol-Woong Lee Seung-Whan Lee Sang-Rok Choi Seung-Hyuk Chae In-Ho Choi Dong-Hoon
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Abstract
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Background and Objectives: Few studies have investigated the obesity paradox in clinical outcomes of peripheral artery disease (PAD). We investigated the association between body mass index (BMI) and clinical outcomes in PAD patients undergoing endovascular therapy (EVT).
Methods: Patients (n=2,914) from the retrospective Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry were categorized according to BMI: underweight (<18.5 kg/m2, n=204), normal weight (18.5?25 kg/m2, n=1,818), overweight (25?30 kg/m2, n=766), or obese (¡Ã30 kg/m2, n=126). Groups were compared for major adverse cardiovascular events (MACE) and major adverse limb events (MALE).
Results: The underweight and obese groups were older and had more frequent critical limb ischemia and infrapopliteal artery disease than the normal or overweight groups (all p<0.001). Hypertension and diabetes were more frequent and current smoking was less frequent in the overweight and obese groups than the underweight or normal weight groups (all p <0.001). The underweight group showed the higher rates of MACE and MALE at 3 years (17.2%, 15.7%) compared with the normal weight (10.8%, 11.7%), overweight (8.4%, 10.7%), or obese groups (8.7%, 14.3%) (log-rank p<0.001, p=0.015). In contrast, the risk of MACE was lower in the overweight than the normal weight group (adjusted hazard ratio, 0.706; 95% CI, 0.537?0.928).
Conclusions: In PAD patients undergoing EVT, underweight was an independent predictor for MACE and MALE, whereas MACE risk was lower for overweight than normal weight patients.
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KEYWORD
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Peripheral artery disease, Body mass index, Endovascular procedure, Prognosis
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