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Tytuł:
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Impact of High Body Mass Index on Vascular and Bleeding Complications After Transcatheter Aortic Valve Implantation.
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Autorzy:
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Berti S; Department of Diagnostic and Interventional Cardiology, Gabriele Monasterio Tuscany Foundation, G. Pasquinucci Heart Hospital, Massa, Italy.
Bartorelli AL; Centro Monzino, IRCCS and Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy.
Koni E; Department of Diagnostic and Interventional Cardiology, Gabriele Monasterio Tuscany Foundation, G. Pasquinucci Heart Hospital, Massa, Italy; Department of Interventional Cardiology, Santa Corona Hospital, Pietra Ligure, Italy.
Giordano A; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.
Petronio AS; Department of Cardiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Iadanza A; Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Siena, Italy.
Bedogni F; Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy.
Reimers B; Cardio Center, Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy.
Spaccarotella C; Division of Cardiology, CCU and Interventional, Cardiology, Cardiovascular Research Center, University Magna Graecia, Catanzaro, Italy.
Trani C; Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Attisano T; Department of Cardiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
Sardella G; Department of Cardiology, Policlinico 'Umberto I,' Sapienza University of Rome, Rome, Italy.
Bonmassari R; Department of Cardiology; S. Chiara Hospital, Trento, Italy.
Medda M; Istituto Clinico Sant'Ambrogio, Gruppo San Donato, Milano, Italy.
Sherwood MW; INOVA Heart and Vascular Institute, Falls Church, Virginia, US.
Tomai F; Division of Cardiology, European Hospital, Rome, Italy.
Navarese EP; Interventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland; Faculty of Medicine, University of Alberta, Edmonton, Canada. Electronic address: .
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Corporate Authors:
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From the RISPEVA registry
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Źródło:
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The American journal of cardiology [Am J Cardiol] 2021 Sep 15; Vol. 155, pp. 86-95. Date of Electronic Publication: 2021 Jul 17.
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Typ publikacji:
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Journal Article; Multicenter Study
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Język:
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English
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Imprint Name(s):
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Original Publication: New York, NY : Excerpta Medica
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MeSH Terms:
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Body Mass Index*
Registries*
Aortic Valve Stenosis/*surgery
Postoperative Hemorrhage/*etiology
Risk Assessment/*methods
Transcatheter Aortic Valve Replacement/*adverse effects
Vascular Diseases/*etiology
Aged, 80 and over ; Female ; Humans ; Incidence ; Italy/epidemiology ; Male ; Postoperative Hemorrhage/epidemiology ; Propensity Score ; Prospective Studies ; Risk Factors ; Time Factors ; Vascular Diseases/epidemiology
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Entry Date(s):
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Date Created: 20210721 Date Completed: 20210921 Latest Revision: 20210921
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Update Code:
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20240105
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DOI:
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10.1016/j.amjcard.2021.06.015
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PMID:
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34284861
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Increased body mass index (BMI) is an established cardiovascular risk factor. The impact of high BMI on vascular and bleeding complications in patients undergoing transcatheter aortic valve implantation (TAVI) is not clarified. RISPEVA, a multicenter prospective database of patients undergoing TAVI stratified by BMI was used for this analysis. Patients were classified as normal or high BMI (obese and overweight) according to the World Health Organization criteria. A comparison of 30-day vascular and bleeding outcomes between groups was performed using propensity scores methods. A total of 3776 matched subjects for their baseline characteristics were included. Compared with normal BMI, high BMI patients had significantly 30-day greater risk of the composite of vascular or bleeding complications (11.1% vs 8.8%, OR: 1.28, 95% CI [1.02 to 1.61]; p = 0.03). Complications rates were higher in both obese (11.3%) and overweight (10.5%), as compared with normal weight patients (8.8%). By a landmark event analysis, the effect of high versus normal BMI on these complications appeared more pronounced within 7 days after the TAVI procedure. A significant linear association between increased BMI and vascular complications was observed at this time frame (p = 0.03). In conclusion, compared with normal BMI, both obese and overweight patients undergoing TAVI, experience increased rates of 30-day vascular and bleeding complications. These findings indicate that high BMI is an independent risk predictor of vascular and bleeding complications after TAVI.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
