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首页> 外文期刊>The American Journal of Cardiology >Body mass index, periprocedural bleeding, and outcome following percutaneous coronary intervention (from the British Columbia Cardiac Registry).
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Body mass index, periprocedural bleeding, and outcome following percutaneous coronary intervention (from the British Columbia Cardiac Registry).

机译：体重指数，围手术期出血和经皮冠状动脉介入治疗后的结局（来自不列颠哥伦比亚省心脏登记处）。

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摘要

The incidence of obesity is increasing throughout the industrialized world and is a major public health concern. Some studies have shown a paradoxical protective effect of moderate obesity on outcome after percutaneous coronary intervention (PCI). The association between bleeding, body mass, and outcome is not well established and formed the basis for the present study, which examined major bleeding rates and mortality after PCI in British Columbia during a 6-year period. We identified 38,346 consecutive patients from the British Columbia Cardiac Registry who underwent PCI from 1999 to 2005. Data were cross-referenced to determine outcomes at 30 days and 1 year. Information about bleeding after PCI was obtained by cross-referencing the British Columbia Cardiac Registry with the Central Transfusion Registry. Baseline patient characteristics were compared among body mass index (BMI) categories. A clear bimodal (U-shaped) relation was seen between BMI and mortality. BMI was a potent independent predictor of mortality, particularly evident in the underweight (BMI <18.5 kg/m(2); odds ratio [OR] 1.98, 95% confidence interval [CI] 1.6 to 2.5, p <0.0001) and morbidly obese (> or =40 kg/m(2); OR 1.61, 95% CI 1.28 to 2.08, p <0.0001) groups. Periprocedural transfusion was also associated with adverse outcome (OR 2.86, 95% CI 2.52 to 3.25, p <0.0001). Transfusion adopted the same bimodal distribution across the entire cohort. Emergent PCI and femoral access were procedural factors associated with outcome. In conclusion, major bleeding conferred an adverse long-term prognosis after PCI. Identifying demographic and procedural factors that increase risk will facilitate more accurate risk scoring of patients undergoing PCI and allow targeted bleeding-avoidance strategies. Body mass and female gender identified subgroups at much higher risk of bleeding after PCI, an observation that merits further study.
机译：在整个工业化世界中，肥胖症的发病率正在增加，这是一个主要的公共卫生问题。一些研究表明，中度肥胖对经皮冠状动脉介入治疗（PCI）后的结局具有反常的保护作用。出血，体重和结局之间的关联尚未得到很好的建立，并构成了本研究的基础，该研究检查了不列颠哥伦比亚省PCI在6年期间的主要出血率和死亡率。我们从1999年至2005年从不列颠哥伦比亚省心脏登记处确定了38346例接受PCI的连续患者。对数据进行交叉参考以确定30天和1年的结局。通过交叉引用不列颠哥伦比亚省心脏登记处与中央输血登记处获得有关PCI后出血的信息。比较了体重指数（BMI）类别中的基线患者特征。 BMI与死亡率之间存在明显的双峰（U形）关系。 BMI是死亡的有效独立预测指标，尤其是在体重过轻（BMI <18.5 kg / m（2）;优势比[OR] 1.98，95％置信区间[CI] 1.6至2.5，p <0.0001）和病态肥胖中（>或= 40 kg / m（2）;或1.61，95％CI 1.28至2.08，p <0.0001）组。围手术期输血也与不良预后相关（OR 2.86，95％CI 2.52至3.25，p <0.0001）。输血在整个队列中采用相同的双峰分布。紧急PCI和股动脉入路是与预后相关的程序因素。总之，PCI后大出血可导致不良的长期预后。确定增加风险的人口统计学和程序因素将有助于更准确地评估接受PCI的患者的风险评分，并采取有针对性的避免出血策略。体重和女性性别确定了PCI后出血风险更高的亚组，这一发现值得进一步研究。

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