超重患者行经导管二尖瓣夹合术（MitraClip®）与正常体重患者相比的生存获益。
Survival benefit of overweight patients undergoing MitraClip® procedure in comparison to normal-weight patients.
机构信息
Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Center for Thrombosis and Hemostasis, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.
出版信息
Clin Cardiol. 2022 Dec;45(12):1236-1245. doi: 10.1002/clc.23897. Epub 2022 Sep 7.
BACKGROUND
The number of MitraClip® implantations increased significantly in recent years. Data regarding the impact of weight class on survival are sparse.
HYPOTHESIS
We hypothesized that weight class influences survival of patients treated with MitraClip® implantation.
METHODS
We investigated in-hospital, 1-year, 3-year, and long-term survival of patients successfully treated with isolated MitraClip® implantation for mitral valve regurgitation (MR) (June 2010-March 2018). Patients were categorized by weight classes, and the impact of weight classes on survival was analyzed.
RESULTS
Of 617 patients (aged 79.2 years; 47.3% females) treated with MitraClip® implantation (June 2010-March 2018), 12 patients were underweight (2.2%), 220 normal weight (40.1%), 237 overweight (43.2%), and 64 obesity class I (11.7%), 12 class II (2.2%), and 4 class III (0.7%). Preprocedural Logistic EuroScore (21.1 points [IQR 14.0-37.1]; 26.0 [18.5-38.5]; 26.0 [18.4-39.9]; 24.8 [16.8-33.8]; 33.0 [25.9-49.2]; 31.6 [13.1-47.6]; p = .291) was comparable between groups. Weight class had no impact on in-hospital death (0.0%; 4.1%; 1.5%; 0.0%; 7.7%; 0.0%; p = .189), 1-year survival (75.0%; 72.0%; 76.9%; 75.0%; 75.0%; 33.3%; p = .542), and 3-year survival (40.0%; 36.8%; 38.2%; 48.6%; 20.0%; 33.3%; p = .661). Compared to normal weight, underweight (hazard ratio [HR]: 1.35 [95% confidence interval [CI]: 0.65-2.79], p = .419), obesity-class I (HR: 0.93 [95% CI: 0.65-1.34], p = .705), class II (HR: 0.39 [95% CI: 0.12-1.24], p = .112), and class III (HR: 1.28 [95% CI: 0.32-5.21], p = .726) did not affect long-term survival. In contrast, overweight was associated with better survival (HR: 1.32 [95% CI: 1.04-1.68], p = .023).
CONCLUSION
Overweight affected the long-term survival of patients undergoing MitraClip® implantation beneficially compared to normal weight.
背景
近年来，MitraClip®植入的数量显著增加。关于体重类别对生存率影响的数据很少。
假设
我们假设体重类别会影响接受 MitraClip®植入治疗的患者的生存率。
方法
我们调查了 617 名（年龄 79.2 岁；女性占 47.3%）因二尖瓣反流（MR）接受单独 MitraClip®植入治疗的患者的住院期间、1 年、3 年和长期生存率（2010 年 6 月至 2018 年 3 月）。患者按体重类别进行分类，并分析体重类别对生存率的影响。
结果
在接受 MitraClip®植入治疗的 617 名患者中（2010 年 6 月至 2018 年 3 月），12 名患者体重过轻（2.2%），220 名体重正常（40.1%），237 名超重（43.2%），64 名肥胖症 I 级（11.7%），12 级（2.2%）和 4 级（0.7%）。术前 Logistic EuroScore（21.1 分[IQR 14.0-37.1]；26.0[18.5-38.5]；26.0[18.4-39.9]；24.8[16.8-33.8]；33.0[25.9-49.2]；31.6[13.1-47.6]；p=0.291）在各组之间无差异。体重类别对住院期间死亡（0.0%；4.1%；1.5%；0.0%；7.7%；0.0%；p=0.189）、1 年生存率（75.0%；72.0%；76.9%；75.0%；75.0%；33.3%；p=0.542）和 3 年生存率（40.0%；36.8%；38.2%；48.6%；20.0%；33.3%；p=0.661）无影响。与体重正常相比，体重过轻（危险比[HR]：1.35[95%置信区间[CI]：0.65-2.79]，p=0.419）、肥胖症 I 级（HR：0.93[95%CI：0.65-1.34]，p=0.705）、II 级（HR：0.39[95%CI：0.12-1.24]，p=0.112）和 III 级（HR：1.28[95%CI：0.32-5.21]，p=0.726）并不影响长期生存率。相比之下，超重与更好的长期生存率相关（HR：1.32[95%CI：1.04-1.68]，p=0.023）。
结论
与体重正常相比，超重对接受 MitraClip®植入治疗的患者的长期生存率有有益影响。
Zotero 插件