Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/21959
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dc.contributor.authorBiswas, Sinjini-
dc.contributor.authorAndrianopoulos, Nick-
dc.contributor.authorDinh, Diem-
dc.contributor.authorDuffy, Stephen J-
dc.contributor.authorLefkovits, Jeffrey-
dc.contributor.authorBrennan, Angela-
dc.contributor.authorNoaman, Samer-
dc.contributor.authorAjani, Andrew-
dc.contributor.authorClark, David J-
dc.contributor.authorFreeman, Melanie-
dc.contributor.authorOqueli, Ernesto-
dc.contributor.authorHiew, Chin-
dc.contributor.authorReid, Christopher M-
dc.contributor.authorStub, Dion-
dc.contributor.authorChan, William-
dc.date2019-11-05-
dc.date.accessioned2019-10-29T05:03:45Z-
dc.date.available2019-10-29T05:03:45Z-
dc.date.issued2019-11-05-
dc.identifier.citationJournal of the American Heart Association 2019; 8(21): e012860en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/21959-
dc.description.abstractBackground Previous studies have reported a protective effect of obesity compared with normal body mass index (BMI) in patients undergoing percutaneous coronary intervention (PCI). However, it is unclear whether this effect extends to the extremely obese. In this large multicenter registry-based study, we sought to examine the relationship between BMI and long-term clinical outcomes following PCI, and in particular to evaluate the association between extreme obesity and long-term survival after PCI. Methods and Results This cohort study included 25 413 patients who underwent PCI between January 1, 2005 and June 30, 2017, who were prospectively enrolled in the Melbourne Interventional Group registry. Patients were stratified by World Health Organization-defined BMI categories. The primary end point was National Death Index-linked mortality. The median length of follow-up was 4.4 years (interquartile range 2.0-7.6 years). Of the study cohort, 24.8% had normal BMI (18.5-24.9 kg/m2), and 3.3% were extremely obese (BMI ≥40 kg/m2). Patients with greater degrees of obesity were younger and included a higher proportion of diabetics (P<0.001). After adjustment for age and comorbidities, a J-shaped association was observed between different BMI categories and adjusted hazard ratio (HR) for long-term mortality (normal BMI, HR 1.00 [ref]; overweight, HR 0.85, 95% CI 0.78-0.93, P<0.001; mild obesity, HR 0.85, 95% CI 0.76-0.94, P=0.002; moderate obesity, HR 0.95, 95% CI 0.80-1.12, P=0.54; extreme obesity HR 1.33, 95% CI 1.07-1.65, P=0.01). Conclusions An obesity paradox is still apparent in contemporary practice, with elevated BMI up to 35 kg/m2 associated with reduced long-term mortality after PCI. However, this protective effect appears not to extend to patients with extreme obesity.en_US
dc.language.isoeng-
dc.subjectlong‐term outcomeen_US
dc.subjectobesityen_US
dc.subjectpercutaneous coronary interventionen_US
dc.titleAssociation of Body Mass Index and Extreme Obesity With Long-Term Outcomes Following Percutaneous Coronary Intervention.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleJournal of the American Heart Associationen_US
dc.identifier.affiliationCardiologyen_US
dc.identifier.affiliationDepartment of Cardiology University Hospital Geelong Geelong Australiaen_US
dc.identifier.affiliationDepartment of Cardiology Box Hill Hospital Melbourne Australiaen_US
dc.identifier.affiliationDepartment of Epidemiology and Preventive Medicine Monash University Melbourne Australiaen_US
dc.identifier.affiliationDepartment of Cardiology The Alfred Hospital Melbourne Australiaen_US
dc.identifier.affiliationDepartment of Cardiology Royal Melbourne Hospital Melbourne Australiaen_US
dc.identifier.affiliationDepartment of Medicine University of Melbourne Melbourne Australiaen_US
dc.identifier.affiliationDepartment of Cardiology Ballarat Health Services Ballarat Australiaen_US
dc.identifier.affiliationSchool of Medicine Deakin University Ballarat Australiaen_US
dc.identifier.affiliationSchool of Public Health Curtin University Perth Australiaen_US
dc.identifier.affiliationBaker IDI Heart and Diabetes Institute Melbourne Australiaen_US
dc.identifier.affiliationDepartment of Medicine Monash University Melbourne Australiaen_US
dc.identifier.doi10.1161/JAHA.119.012860en_US
dc.type.contentTexten_US
dc.identifier.pubmedid31648578-
dc.type.austinJournal Article-
local.name.researcherClark, David J
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptCardiology-
crisitem.author.deptUniversity of Melbourne Clinical School-
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