| Impact of body mass index on the outcome of patients with multivessel disease randomized to either coronary artery bypass grafting or stenting in the ARTS trial: The obesity paradox II? | |
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MedLine Citation:
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PMID: 15695125 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effect of body mass index (BMI) on outcomes after coronary artery revascularization remains controversial. We studied 1,203 patients who had multivessel coronary artery disease and underwent stenting (n = 599) or coronary artery bypass grafting (CABG; n = 604) in the Arterial Revascularization Therapies Study. Patients were assigned to 1 of 3 groups according to BMI: <25, 25 to 30, and >30 kg/m(2). At 3-year follow-up, the incidence of death, cerebrovascular events, or myocardial infarction was similar for these BMI categories regardless of the revascularization technique used. Rates of repeat revascularization procedures were significantly higher among patients who had been randomized to stenting but were similar across BMI groups. For patients who had been randomized to undergo CABG, there was a significant decrease in repeat revascularization procedures in obese patients (p = 0.03). Among patients who underwent stenting, BMI had no effect on the 3-year combined end point of rate of major adverse cardiac or cerebrovascular events. Among patients who underwent CABG, major adverse cardiac or cerebrovascular event rates were significantly lower for patients who were obese (11%) or overweight (16%) compared with patients who had a normal BMI (24%; p = 0.008). Thus, in a large cohort of patients who had multivessel coronary artery disease and underwent surgical or percutaneous revascularization, BMI had no effect on 3-year outcome of those who underwent stenting. Conversely, among patients who underwent CABG, those who were overweight or obese had a significantly better outcome than did those who had a normal BMI with regard to survival without major adverse cardiac or cerebrovascular events, mainly due to lower rates of repeat revascularization procedures. |
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Authors:
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Luis Gruberg; Nestor Mercado; Simcha Milo; Eric Boersma; Clemens Disco; Gerrit-Anne van Es; Pedro A Lemos; Margalit Ben Tzvi; William Wijns; Felix Unger; Rafael Beyar; Patrick W Serruys; |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial |
Journal Detail:
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Title: The American journal of cardiology Volume: 95 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2005 Feb |
Date Detail:
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Created Date: 2005-02-07 Completed Date: 2005-04-05 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 439-44 Citation Subset: AIM; IM |
Affiliation:
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Division of Invasive Cardiology, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Body Mass Index Coronary Artery Bypass* Coronary Disease / mortality, therapy* Europe / epidemiology Female Humans Male Middle Aged Myocardial Infarction / epidemiology Obesity / epidemiology* Outcome Assessment (Health Care)* Reoperation / statistics & numerical data Stents* Stroke / epidemiology Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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