Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas, USA.
Am J Cardiol. 2011 Dec 15;108(12):1767-71. doi: 10.1016/j.amjcard.2011.09.010. Epub 2011 Oct 12.
The purpose of this report is to describe the effect of body mass index (BMI) on 30-day and late outcome in patients having aortic valve replacement (AVR) for aortic stenosis (AS) with or without concomitant coronary artery bypass grafting. From January 2002 through June 2010 (8.5 years), 1,040 operatively excised stenotic aortic valves were submitted to the cardiovascular laboratory at Baylor University Medical Center at Dallas. Of the 1,040 cases 175 were eliminated because they had a previous cardiac operation. The present study included 865 adults whose AVR for AS was their first cardiac operation. Propensity-adjusted analysis showed that 30-day and late mortality were strongly and significantly associated with BMI. Decreased risk of 30-day and long-term mortality was observed for patients with BMI in the low 30s compared to patients with BMI in the mid 20s or >40 kg/m(2). In conclusion, the findings in this study indicate a strong and significant adjusted association between BMI and 30-day and long-term mortality in patients having AVR for AS with or without concomitant coronary artery bypass grafting. Better survival was observed in patients with BMIs in the low 30s compared to patients with BMIs in the mid 20s and >40 kg/m(2).
本报告的目的是描述体重指数(BMI)对接受主动脉瓣置换术(AVR)治疗主动脉瓣狭窄(AS)合并或不合并冠状动脉旁路移植术患者的 30 天和晚期结局的影响。2002 年 1 月至 2010 年 6 月(8.5 年)期间,在达拉斯贝勒大学医学中心的心血管实验室提交了 1040 个手术切除的狭窄主动脉瓣。在 1040 例中,有 175 例因之前有心脏手术而被排除在外。本研究包括 865 名接受 AVR 治疗 AS 的成年人,这是他们的首次心脏手术。倾向评分调整分析显示,30 天和晚期死亡率与 BMI 呈强烈和显著相关。与 BMI 处于 20 多岁中期或>40kg/m(2)的患者相比,BMI 处于 30 多岁低位的患者 30 天和长期死亡率的风险降低。总之,本研究的结果表明,在接受 AVR 治疗 AS 合并或不合并冠状动脉旁路移植术的患者中,BMI 与 30 天和长期死亡率之间存在强烈和显著的调整关联。与 BMI 处于 20 多岁中期和>40kg/m(2)的患者相比,BMI 处于 30 多岁低位的患者生存率更好。