Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.

<h4>Background</h4>It is still unclear whether body mass index (BMI) affects bleeding and cardiovascular events in patients requiring oral anticoagulants (OAC) for atrial fibrillation (AF) and antiplatelet agents after percutaneous coronary intervention (PCI) for coronary artery disease...

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Main Authors: Tatsuro Yamazaki, Hideki Kitahara, Daichi Yamashita, Takanori Sato, Sakuramaru Suzuki, Takashi Hiraga, Tadahiro Matsumoto, Takahiro Kobayashi, Yuji Ohno, Junya Harada, Kenichi Fukushima, Tatsuhiko Asano, Naoki Ishio, Raita Uchiyama, Hirofumi Miyahara, Shinichi Okino, Masanori Sano, Nehiro Kuriyama, Masashi Yamamoto, Naoya Sakamoto, Junji Kanda, Yoshio Kobayashi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0309758
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author Tatsuro Yamazaki
Hideki Kitahara
Daichi Yamashita
Takanori Sato
Sakuramaru Suzuki
Takashi Hiraga
Tadahiro Matsumoto
Takahiro Kobayashi
Yuji Ohno
Junya Harada
Kenichi Fukushima
Tatsuhiko Asano
Naoki Ishio
Raita Uchiyama
Hirofumi Miyahara
Shinichi Okino
Masanori Sano
Nehiro Kuriyama
Masashi Yamamoto
Naoya Sakamoto
Junji Kanda
Yoshio Kobayashi
author_facet Tatsuro Yamazaki
Hideki Kitahara
Daichi Yamashita
Takanori Sato
Sakuramaru Suzuki
Takashi Hiraga
Tadahiro Matsumoto
Takahiro Kobayashi
Yuji Ohno
Junya Harada
Kenichi Fukushima
Tatsuhiko Asano
Naoki Ishio
Raita Uchiyama
Hirofumi Miyahara
Shinichi Okino
Masanori Sano
Nehiro Kuriyama
Masashi Yamamoto
Naoya Sakamoto
Junji Kanda
Yoshio Kobayashi
author_sort Tatsuro Yamazaki
collection DOAJ
description <h4>Background</h4>It is still unclear whether body mass index (BMI) affects bleeding and cardiovascular events in patients requiring oral anticoagulants (OAC) for atrial fibrillation (AF) and antiplatelet agents after percutaneous coronary intervention (PCI) for coronary artery disease (CAD). The aim of this study was to evaluate the relationship between BMI and clinical events in patients who underwent PCI under OAC therapy for AF.<h4>Method</h4>This was a multicenter, observational cohort study conducted at 15 institutions in Japan. AF patients who underwent PCI with drug-eluting stents for CAD were retrospectively and prospectively included. Patients were divided into the Group 1 (BMI <21.3 kg/m2) and the Group 2 (BMI ≥21.3 kg/m2) according to the first-quartile value of BMI. The primary endpoint was net adverse clinical events (NACE), a composite of major adverse cardiovascular events (MACE) and major bleeding events within one year after index PCI procedure.<h4>Results</h4>In the 720 patients, 180 patients (25.0%) had BMI value <21.3 kg/m2. While the rates of NACE and MACE were significantly higher in the Group 1 than the counterpart (21.1% vs. 11.9%, p = 0.003 and 17.2% vs. 8.9%, p = 0.004), that of major bleeding did not differ significantly between the 2 groups (5.6% vs. 4.3%, p = 0.54). The cumulative rate of NACE and MACE was significantly higher in the Group 1 than the Group 2 (both log-rank p = 0.002), although that of major bleeding events was equivalent between the 2 groups (log-rank p = 0.41). In multivariable Cox regression analyses, while BMI value <21.3 kg/m2 was not associated with major bleeding events, that cut-off value was an independent predictor for increased NACE and MACE.<h4>Conclusions</h4>Among the patients undergoing PCI for CAD and requiring OAC for AF, BMI value was a useful indicator to predict major adverse clinical events.
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spelling doaj-art-4af648a5edfa45a8bf500fea85e69e512025-01-26T05:31:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01199e030975810.1371/journal.pone.0309758Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.Tatsuro YamazakiHideki KitaharaDaichi YamashitaTakanori SatoSakuramaru SuzukiTakashi HiragaTadahiro MatsumotoTakahiro KobayashiYuji OhnoJunya HaradaKenichi FukushimaTatsuhiko AsanoNaoki IshioRaita UchiyamaHirofumi MiyaharaShinichi OkinoMasanori SanoNehiro KuriyamaMasashi YamamotoNaoya SakamotoJunji KandaYoshio Kobayashi<h4>Background</h4>It is still unclear whether body mass index (BMI) affects bleeding and cardiovascular events in patients requiring oral anticoagulants (OAC) for atrial fibrillation (AF) and antiplatelet agents after percutaneous coronary intervention (PCI) for coronary artery disease (CAD). The aim of this study was to evaluate the relationship between BMI and clinical events in patients who underwent PCI under OAC therapy for AF.<h4>Method</h4>This was a multicenter, observational cohort study conducted at 15 institutions in Japan. AF patients who underwent PCI with drug-eluting stents for CAD were retrospectively and prospectively included. Patients were divided into the Group 1 (BMI <21.3 kg/m2) and the Group 2 (BMI ≥21.3 kg/m2) according to the first-quartile value of BMI. The primary endpoint was net adverse clinical events (NACE), a composite of major adverse cardiovascular events (MACE) and major bleeding events within one year after index PCI procedure.<h4>Results</h4>In the 720 patients, 180 patients (25.0%) had BMI value <21.3 kg/m2. While the rates of NACE and MACE were significantly higher in the Group 1 than the counterpart (21.1% vs. 11.9%, p = 0.003 and 17.2% vs. 8.9%, p = 0.004), that of major bleeding did not differ significantly between the 2 groups (5.6% vs. 4.3%, p = 0.54). The cumulative rate of NACE and MACE was significantly higher in the Group 1 than the Group 2 (both log-rank p = 0.002), although that of major bleeding events was equivalent between the 2 groups (log-rank p = 0.41). In multivariable Cox regression analyses, while BMI value <21.3 kg/m2 was not associated with major bleeding events, that cut-off value was an independent predictor for increased NACE and MACE.<h4>Conclusions</h4>Among the patients undergoing PCI for CAD and requiring OAC for AF, BMI value was a useful indicator to predict major adverse clinical events.https://doi.org/10.1371/journal.pone.0309758
spellingShingle Tatsuro Yamazaki
Hideki Kitahara
Daichi Yamashita
Takanori Sato
Sakuramaru Suzuki
Takashi Hiraga
Tadahiro Matsumoto
Takahiro Kobayashi
Yuji Ohno
Junya Harada
Kenichi Fukushima
Tatsuhiko Asano
Naoki Ishio
Raita Uchiyama
Hirofumi Miyahara
Shinichi Okino
Masanori Sano
Nehiro Kuriyama
Masashi Yamamoto
Naoya Sakamoto
Junji Kanda
Yoshio Kobayashi
Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.
PLoS ONE
title Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.
title_full Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.
title_fullStr Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.
title_full_unstemmed Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.
title_short Relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention.
title_sort relationship between body mass index and clinical events in patients with atrial fibrillation undergoing percutaneous coronary intervention
url https://doi.org/10.1371/journal.pone.0309758
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