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dc.contributor.authorLancefield, Teraseen
dc.contributor.authorClark, David Jen
dc.contributor.authorAndrianopoulos, Nicken
dc.contributor.authorBrennan, Angela Len
dc.contributor.authorReid, Christopher Men
dc.contributor.authorJohns, Jenniferen
dc.contributor.authorFreeman, Melanieen
dc.contributor.authorCharter, Kerrieen
dc.contributor.authorDuffy, Stephen Jen
dc.contributor.authorAjani, Andrew Een
dc.contributor.authorProietto, Josephen
dc.contributor.authorFarouque, Omaren
dc.identifier.citationJacc. Cardiovascular Interventions; 3(6): 660-8en
dc.description.abstractWe sought to determine whether an obesity paradox exists in the contemporary era of percutaneous coronary intervention (PCI) and to explore potential clinical factors that might contribute.Previous studies have suggested that overweight and obese patients might have better outcomes after PCI than patients with a normal or low body mass index (BMI); however this "obesity paradox" remains poorly understood.We evaluated 4,762 patients undergoing PCI between April 1, 2004 and September 30, 2007, enrolled in the MIG (Melbourne Intervention Group) registry. Patients were classified as underweight, normal, overweight, class I obese, and class II to III obese, BMI <20, 20 to 25, 25.1 to 30, 30.1 to 35, and >35 kg/m(2), respectively. We compared in-hospital, 30-day, and 12-month outcomes.As BMI increased from <20 to >35 kg/m(2), there was a statistically significant, linear reduction in 12-month major adverse cardiac events (MACE) (21.4% to 11.9%, p = 0.008) and mortality (7.6% to 2.0%, p < 0.001). Obesity was, with multivariate analysis, an independent predictor of reduced 12-month MACE and showed a trend for reduced 12-month mortality. At 12 months, obese patients had higher use of aspirin, clopidogrel, beta-blockers, renin-angiotensin system blockers and statins.Compared with normal-weight individuals, overweight and obese patients had lower in-hospital and 12-month MACE and mortality rates after PCI. Moreover, obese patients had a higher rate of guideline-based medication use at 12 months, which might in part explain the obesity paradox seen after PCI.en
dc.subject.otherAged, 80 and overen
dc.subject.otherAngioplasty, Balloon, Coronary.adverse effects.mortalityen
dc.subject.otherBody Mass Indexen
dc.subject.otherCardiovascular Agents.therapeutic useen
dc.subject.otherCardiovascular Diseases.etiologyen
dc.subject.otherChi-Square Distributionen
dc.subject.otherCoronary Artery Disease.complications.mortality.therapyen
dc.subject.otherHospital Mortalityen
dc.subject.otherKaplan-Meier Estimateen
dc.subject.otherLogistic Modelsen
dc.subject.otherMiddle Ageden
dc.subject.otherRetrospective Studiesen
dc.subject.otherRisk Assessmenten
dc.subject.otherRisk Factorsen
dc.subject.otherTime Factorsen
dc.subject.otherTreatment Outcomeen
dc.titleIs there an obesity paradox after percutaneous coronary intervention in the contemporary era? An analysis from a multicenter Australian registry.en
dc.typeJournal Articleen
dc.identifier.journaltitleJACC. Cardiovascular interventionsen
dc.identifier.affiliationDepartment of Cardiology, Austin Health, Melbourne, Australiaen
dc.contributor.corpauthorMIG (Melbourne Interventional Group) Registryen
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