肥胖与接受冠状动脉造影的患者长期预后受损相关：来自一项大型单中心登记研究的结果。

Obesity is associated with impaired long-term prognosis in patients undergoing coronary angiography: Results from a large-scaled single centre registry.

作者信息

Kuhn Lasse, Akin Ibrahim, Steinke Philipp, Abumayyaleh Mohammad, Ayoub Mohamed, Mashayekhi Kambis, Jannesari Mahboubeh, Siegel Fabian, Duerschmied Daniel, Behnes Michael, Schupp Tobias

机构信息

Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.

Division of Cardiology and Angiology, Heart Center University of Bochum - Bad Oeynhausen, Germany.

出版信息

Int J Cardiol. 2025 Jul 15;431:133252. doi: 10.1016/j.ijcard.2025.133252. Epub 2025 Apr 8.

DOI:10.1016/j.ijcard.2025.133252

PMID:40209941

Abstract

BACKGROUND

The study investigates the prognostic value of body mass index (BMI) in a large cohort of unselected patients undergoing invasive coronary angiography (CA). More than one third of the world population is overweight or obese with increasing prevalence. Obesity is an established risk factor for the development of coronary artery disease (CAD), but its impact on outcomes in patients undergoing CA remains controversial.

METHODS

Consecutive patients undergoing invasive CA were included at one institution from 2016 to 2022. Patients were stratified by BMI on admission according to the current WHO definition into the following subgroups: BMI 18.5- < 25 kg/m, 25- < 30 kg/m, 30- < 35 kg/m and ≥ 35 kg/m. The prognostic value of BMI was investigated with regard to the primary endpoint rehospitalization for heart failure (HF) at 36 months and the secondary endpoints acute myocardial infarction (AMI) and coronary revascularization at 36 months.

RESULTS

From 2016 to 2022, 6583 patients undergoing CA were included with a median BMI of 27.5 kg/m (mean: 28.3 kg/m). Patients with a BMI of 25- < 30 kg/m had the highest prevalence of CAD (71.1 %) and 3-vessel CAD (30.5 %), whereas patients with a BMI ≥ 35 kg/m had the lowest prevalence (61.4 % and 20.1 %, respectively). After multivariable adjustment, patients with a BMI ≥ 35 kg/m had the highest risk of HF-related rehospitalization at 36 months compared to those with a BMI in the normal range (adjusted HR = 1.210; 95 % CI: 1.011-1.448; p = 0.038).

CONCLUSION

In patients undergoing CA, a BMI ≥35 kg/m was associated with the highest risk of HF-related rehospitalization at 36 months.

摘要

背景

本研究调查了体重指数（BMI）在一大群未经选择的接受有创冠状动脉造影（CA）患者中的预后价值。世界上超过三分之一的人口超重或肥胖，且患病率不断上升。肥胖是冠状动脉疾病（CAD）发生的既定危险因素，但其对接受CA患者预后的影响仍存在争议。

方法

2016年至2022年期间，在一家机构纳入连续接受有创CA的患者。根据世界卫生组织当前定义，患者入院时按BMI分层为以下亚组：BMI 18.5 - <25kg/m、25 - <30kg/m、30 - <35kg/m和≥35kg/m。研究了BMI对36个月时心力衰竭（HF）再住院这一主要终点以及36个月时急性心肌梗死（AMI）和冠状动脉血运重建这两次要终点的预后价值。

结果

2016年至2022年期间，纳入了6583例接受CA的患者，中位BMI为27.5kg/m（平均：28.3kg/m）。BMI为25 - <30kg/m的患者CAD患病率最高（71.1%），三支血管CAD患病率最高（30.5%），而BMI≥35kg/m的患者患病率最低（分别为61.4%和20.1%）。多变量调整后，与BMI在正常范围的患者相比，BMI≥35kg/m的患者在36个月时因HF相关再住院的风险最高（调整后HR = 1.210；95%CI：1.011 - 1.448；p = 0.038）。