Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, 11000 Belgrade, Serbia.
Int J Environ Res Public Health. 2023 Feb 2;20(3):2692. doi: 10.3390/ijerph20032692.
A cohort study was conducted to examine the association of an increased body mass index (BMI) with late adverse outcomes after a carotid endarterectomy (CEA). It comprised 1597 CEAs, performed in 1533 patients at the Vascular Surgery Clinic in Belgrade, from 1 January 2012 to 31 December 2017. The follow-up lasted four years after CEA. Data for late myocardial infarction and stroke were available for 1223 CEAs, data for death for 1305 CEAs, and data for restenosis for 1162 CEAs. Logistic and Cox regressions were used in the analysis. The CEAs in patients who were overweight and obese were separately compared with the CEAs in patients with a normal weight. Out of 1223 CEAs, 413 (33.8%) were performed in patients with a normal weight, 583 (47.7%) in patients who were overweight, and 220 (18.0%) in patients who were obese. According to the logistic regression analysis, the compared groups did not significantly differ in the frequency of myocardial infarction, stroke, and death, as late major adverse outcomes (MAOs), or in the frequency of restenosis. According to the Cox and logistic regression analyses, BMI was neither a predictor for late MAOs, analyzed separately or all together, nor for restenosis. In conclusion, being overweight and being obese were not related to the occurrence of late adverse outcomes after a carotid endarterectomy.
一项队列研究旨在探讨颈动脉内膜切除术(CEA)后体重指数(BMI)升高与晚期不良结局的关系。该研究共纳入了 1533 例患者的 1597 例 CEA,这些患者均于 2012 年 1 月 1 日至 2017 年 12 月 31 日在贝尔格莱德血管外科诊所接受治疗。CEA 后的随访时间为 4 年。有 1223 例 CEA 可获得晚期心肌梗死和中风的数据,1305 例 CEA 可获得死亡数据,1162 例 CEA 可获得再狭窄数据。分析中使用了逻辑回归和 Cox 回归。超重和肥胖患者的 CEA 分别与体重正常患者的 CEA 进行比较。在 1223 例 CEA 中,413 例(33.8%)在体重正常的患者中进行,583 例(47.7%)在超重的患者中进行,220 例(18.0%)在肥胖的患者中进行。根据逻辑回归分析,作为晚期主要不良结局(MAO)的心肌梗死、中风和死亡的发生率,以及再狭窄的发生率,比较组之间没有显著差异。根据 Cox 和逻辑回归分析,BMI 既不是晚期 MAO 的预测因素,也不是再狭窄的预测因素,无论是单独分析还是全部分析。总之,超重和肥胖与颈动脉内膜切除术后晚期不良结局的发生无关。