Guelker Jan-Erik, Bufe Alexander, Blockhaus Christian, Gesenberg Jan, Kuervers Julian, Kroeger Knut, Katoh Marcus, Dinh Wilfried
Heartcentre Niederrhein, Department of Cardiology, Helios Clinic Krefeld, Krefeld, GermanyGermany.
Institute for Heart and Circulation Research, University Cologne, Cologne, GermanyGermany.
J Saudi Heart Assoc. 2019 Oct;31(4):198-203. doi: 10.1016/j.jsha.2019.06.003. Epub 2019 Jun 24.
Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about the influence of body mass index (BMI) on acute outcome, including success rates and complications in CTO-PCI.
Between 2012 and 2017, we included 508 patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention. BMI was calculated according to the definitions of the World Health Organization. It was subdivided as normal weight (18.5-24.9 kg/m), overweight (25-29.9 kg/m), obese (30-34.9 kg/m), and very obese (≥35 kg/m). The Shapiro-Wilk test was used to test for normality of distribution. Continuous variables were tested for differences with Kruskal-Wallis or Mann-Whitney test as appropriate. Categorical variables were tested with Fisher exact test.
Out of the 508 patients, 77 (15.2%) had normal weight, 286 (56.3%) were overweight, 106 (20.9%) obese, and 39 (7.7%) very obese. Radiation dose and examination time increased with elevated BMI categories ( < 0.001, = 0.026). Success rates were similar in all BMI categories ( = 0.645). In-hospital procedural complications were rare and showed no statistically significant difference ( = 0.185).
Our retrospective study suggests that there exists no significant association between overweight and acute outcome in patients undergoing CTO-PCI. It is safe and feasible to perform.
完全慢性闭塞病变（CTO）的经皮冠状动脉介入治疗（PCI）仍是介入心脏病学中的一项重大挑战。关于体重指数（BMI）对急性结局（包括CTO-PCI的成功率和并发症）的影响，文献中报道的知识非常有限。
2012年至2017年期间，我们纳入了508例患者。他们至少对一处CTO病变进行了PCI治疗。采用了正向和逆向CTO技术。仅在正向干预失败后才使用逆向方法。根据世界卫生组织的定义计算BMI。将其细分为正常体重（18.5-24.9 kg/m）、超重（25-29.9 kg/m）、肥胖（30-34.9 kg/m）和极度肥胖（≥35 kg/m）。使用Shapiro-Wilk检验来检验分布的正态性。连续变量根据情况使用Kruskal-Wallis或Mann-Whitney检验来检验差异。分类变量使用Fisher精确检验。
在508例患者中，77例（15.2%）体重正常，286例（56.3%）超重，106例（20.9%）肥胖，39例（7.7%）极度肥胖。辐射剂量和检查时间随着BMI类别升高而增加（<0.001，=0.026）。所有BMI类别中的成功率相似（=0.645）。院内手术并发症很少，且无统计学显著差异（=0.185）。
我们的回顾性研究表明，在接受CTO-PCI的患者中，超重与急性结局之间不存在显著关联。进行该治疗是安全可行的。
