Kokura Memorial Hospital, Department of Cardiology, Kitakyushu, Japan.
Kokura Memorial Hospital, Department of Cardiology, Kitakyushu, Japan.
Eur J Vasc Endovasc Surg. 2015 Mar;49(3):297-305. doi: 10.1016/j.ejvs.2014.10.014. Epub 2014 Dec 15.
To investigate the relationship between body mass index (BMI) and long-term outcomes of patients with CLI after endovascular treatment (EVT).
Retrospective multicenter study.
1088 consecutive patients (1306 limbs, mean age 72 ± 10 years) with CLI who underwent EVT for isolated infrapopliteal artery lesions were evaluated. These subjects were identified in the J-BEAT III registry.
The patients were divided into groups based on BMI <18.5 kg/m2 (underweight, n = 188; 219 limbs), 18.5 to 24.9 kg/m2 (normal weight, n = 718; 868 limbs), and >25.0 kg/m2 (overweight/obese, n = 182; 219 limbs). The endpoints were overall survival and freedom from major adverse limb events (MALE).
The median follow up period was 1.5 years (range: 1 month-8.7 years). The 3 year overall survival rates were 33.3%, 61.2%, and 69.8% in underweight, normal, and overweight/obese patients, respectively. The survival rate was significantly lower in underweight patients and significantly higher in overweight/obese patients compared with patients of normal weight (both p < .0001). The 3 year rates of freedom from MALE did not differ significantly among the three groups (36.4%, 45.4%, and 52.3%, respectively, p = .32). Age, BMI <18.5 kg/m2, heart failure, aortic valve stenosis, renal failure, triglyceride levels, serum albumin <3.0 g/dL, anticoagulant treatment, non-ambulatory status, and Rutherford 6 classification all were significantly associated with overall survival.
BMI has a complex correlation with mortality in patients with CLI after EVT for isolated infrapopliteal artery lesions. Underweight patients with CLI have an extremely poor prognosis. Such patients have many other factors associated with mortality, but low BMI was identified as an independent predictor of a poor prognosis in patients with CLI. Similarly, normal weight patients had a small but significant increase in mortality compared with overweight/obese patients.
研究血管内治疗（EVT）后 CLI 患者的体重指数（BMI）与长期结局的关系。
回顾性多中心研究。
1088 例连续接受 EVT 治疗孤立性腘动脉病变的 CLI 患者（1306 条肢体，平均年龄 72±10 岁）进行评估。这些患者是在 J-BEAT III 登记处确定的。
根据 BMI<18.5kg/m2（体重不足，n=188；219 条肢体）、18.5-24.9kg/m2（正常体重，n=718；868 条肢体）和>25.0kg/m2（超重/肥胖，n=182；219 条肢体）将患者分为三组。终点是总体生存率和免于主要不良肢体事件（MALE）。
中位随访时间为 1.5 年（范围：1 个月-8.7 年）。体重不足、正常和超重/肥胖患者的 3 年总生存率分别为 33.3%、61.2%和 69.8%。与正常体重患者相比，体重不足患者的生存率明显较低，超重/肥胖患者的生存率明显较高（均 p<.0001）。三组之间免于 MALE 的 3 年率无显著差异（分别为 36.4%、45.4%和 52.3%，p=.32）。年龄、BMI<18.5kg/m2、心力衰竭、主动脉瓣狭窄、肾衰竭、甘油三酯水平、血清白蛋白<3.0g/dL、抗凝治疗、非活动状态和 Rutherford 6 分类均与总体生存率显著相关。
BMI 与 EVT 治疗孤立性腘动脉病变后 CLI 患者的死亡率之间存在复杂的相关性。CLI 体重不足的患者预后极差。此类患者有许多其他与死亡率相关的因素，但低 BMI 被确定为 CLI 患者预后不良的独立预测因素。同样，与超重/肥胖患者相比，正常体重患者的死亡率略有但显著增加。
