体重指数对第二代药物洗脱支架植入术后长期临床结局的影响：来自国际全球RESOLUTE项目的见解

Impact of body mass index on long-term clinical outcomes after second-generation drug eluting stent implantation: Insights from the international global RESOLUTE program.

作者信息

Diletti Roberto, Garcia-Garcia Hector M, Bourantas Christos, Van Mieghem Nicolas M, van Geuns Robert Jan, Muramatsu Takashi, Zhang Yao-Jun, Mauri Laura, Belardi Jorge, Silber Sigmund, Widimsky Petr, Leon Martin, Windecker Stephan, Meredith Ian, Neumann Franz-Josef, Yeung Alan C, Saito Shigeru, Liu Minglei, van Leeuwen Frank, Serruys Patrick W

机构信息

Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.

出版信息

Catheter Cardiovasc Interv. 2015 May;85(6):952-8. doi: 10.1002/ccd.25828. Epub 2015 Feb 17.

DOI:10.1002/ccd.25828

PMID:25689692

Abstract

BACKGROUND

An increased body mass index (BMI) is associated with a high risk of cardiovascular disease and reduction in life expectancy. However, several studies reported improved clinical outcomes in obese patients treated for cardiovascular diseases. The aim of the present study is to investigate the impact of BMI on long-term clinical outcomes after implantation of zotarolimus eluting stents.

METHODS

Individual patient data were pooled from the RESOLUTE Clinical Program comprising five trials worldwide. The study population was sorted according to BMI tertiles and clinical outcomes were evaluated at 2-year follow-up.

RESULTS

Data from a total of 5,127 patients receiving the R-ZES were included in the present study. BMI tertiles were as follow: I tertile (≤ 25.95 kg/m(2) -Low or normal weight) 1,727 patients; II tertile (>25.95 ≤ 29.74 kg/m(2) -overweight) 1,695 patients, and III tertile (>29.74 kg/m(2) -obese) 1,705 patients. At 2-years follow-up no difference was found for patients with high BMI (III tertile) compared with patients with normal or low BMI (I tertile) in terms of target lesion failure (I-III tertile, HR [95% CI] = 0.89 [0.69, 1.14], P = 0.341; major adverse cardiac events (I-III tertile, HR [95% CI] = 0.90 [0.72, 1.14], P = 0.389; cardiac death (I-III tertile, HR [95% CI] = 1.20 [0.73, 1.99], P = 0.476); myocardial infarction (I-III tertile, HR [95% CI] = 0.86 [0.55, 1.35], P = 0.509; clinically-driven target lesion revascularization (I-III tertile, HR [95% CI] = 0.75 [0.53, 1.08], P = 0.123; definite or probable stent thrombosis (I-III tertile, HR [95% CI] = 0.98 [0.49, 1.99], P = 0.964.

CONCLUSIONS

In the present study, the patients' body mass index was found to have no impact on long-term clinical outcomes after coronary artery interventions.

摘要

背景

体重指数（BMI）升高与心血管疾病高风险及预期寿命缩短相关。然而，多项研究报告称，接受心血管疾病治疗的肥胖患者临床结局有所改善。本研究旨在探讨BMI对佐他莫司洗脱支架植入术后长期临床结局的影响。

方法

从全球五项试验组成的RESOLUTE临床项目中汇总个体患者数据。根据BMI三分位数对研究人群进行分类，并在2年随访时评估临床结局。

结果

本研究纳入了共5127例接受R-ZES的患者的数据。BMI三分位数如下：第一三分位数（≤25.95kg/m² - 低体重或正常体重）1727例患者；第二三分位数（>25.95≤29.74kg/m² - 超重）1695例患者，第三三分位数（>29.74kg/m² - 肥胖）1705例患者。在2年随访时，高BMI患者（第三三分位数）与正常或低BMI患者（第一三分位数）相比，在靶病变失败（第一至第三三分位数，HR[95%CI]=0.89[0.69,1.14]，P=0.341）、主要不良心脏事件（第一至第三三分位数，HR[95%CI]=0.90[0.72,1.14]，P=0.389）、心源性死亡（第一至第三三分位数，HR[95%CI]=1.20[0.73,1.99]，P=0.476）、心肌梗死（第一至第三三分位数，HR[95%CI]=0.86[0.55,1.35]，P=0.509）、临床驱动的靶病变血运重建（第一至第三三分位数，HR[95%CI]=0.75[0.53,1.08]，P=0.123）、明确或可能的支架血栓形成（第一至第三三分位数，HR[95%CI]=0.98[0.49,1.99]，P=0.964）方面未发现差异。