Cardiovascular Surgery Department, Tehran Heart Center, Tehran University of Medical Sciences, Iran.
Arch Med Res. 2009 Oct;40(7):618-24. doi: 10.1016/j.arcmed.2009.10.005.
Obesity is a well-known risk factor for development of diabetes, hypertension, and coronary artery disease. However, the obesity paradox shows that short-term outcome has been reported to be superior after revascularization in overweight patients. We conducted this study to examine this theory in patients who were candidates for coronary artery bypass graft and to determine if there is a relationship between obesity and the severity of coronary artery involvement and left main disease in Iranian patients.
A total of 15,550 patients who had undergone isolated coronary artery bypass graft were studied retrospectively. All medical records of the aforementioned patients were derived from our hospital surgery data bank. Preoperative angiography was used for angiographic data.
After adjusting for confounding variables, we still found a significant relationship with higher BMI and lower prevalence of left main disease.
We found that despite a higher prevalence of hypertension, diabetes mellitus, and dyslipidemia, overweight and obese patients who were candidates for coronary artery bypass graft surgery were significantly less likely to have left main disease according to preoperative angiography. This study suggests that obese patients are more likely to be referred for coronary artery bypass graft in earlier stages of coronary involvement.
肥胖是糖尿病、高血压和冠状动脉疾病发展的已知危险因素。然而，肥胖悖论表明，超重患者在血管重建后的短期预后更好。我们进行这项研究是为了在冠状动脉旁路移植术的候选患者中检验这一理论，并确定肥胖与冠状动脉受累的严重程度和伊朗患者左主干疾病之间是否存在关系。
对 15550 例接受单纯冠状动脉旁路移植术的患者进行回顾性研究。上述患者的所有病历均来自我院手术数据库。术前血管造影用于获取血管造影数据。
在调整混杂变量后，我们仍然发现 BMI 较高与左主干疾病发生率较低之间存在显著关系。
我们发现，尽管超重和肥胖患者的高血压、糖尿病和血脂异常发生率较高，但根据术前血管造影，他们患左主干疾病的可能性显著较低。这项研究表明，肥胖患者更有可能在冠状动脉受累的早期阶段被转介进行冠状动脉旁路移植术。
