Body Mass Index and Major Adverse Events During Chronic Antiplatelet Monotherapy After Percutaneous Coronary Intervention With Drug-Eluting Stents-Results From the HOST-EXAM Trialopen access
- Authors
- Won, Ki-Bum; Shin, Eun-Seok; Kang, Jeehoon; Yang, Han-Mo; Park, Kyung Woo; Han, Kyoo-Rok; Moon, Keon-Woong; Oh, Seok Kyu; Kim, Ung; Rhee, Moo-Yong; Kim, Doo-Il; Kim, Song-Yi; Lee, Sung-Yun; Han, Jung-Kyu; Koo, Bon-Kwon; Kim, Hyo-Soo
- Issue Date
- Jan-2023
- Publisher
- JAPANESE CIRCULATION SOC
- Keywords
- Antiplatelet; Body mass index; Drug-eluting stents; Percutaneous coronary intervention; Prognosis
- Citation
- CIRCULATION JOURNAL, v.87, no.2, pp 268 - 276
- Pages
- 9
- Journal Title
- CIRCULATION JOURNAL
- Volume
- 87
- Number
- 2
- Start Page
- 268
- End Page
- 276
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/75237
- DOI
- 10.1253/circj.CJ-22-0344
- ISSN
- 1346-9843
1347-4820
- Abstract
- Background: This study evaluated the association of body mass index (BMI) with adverse clinical outcomes during chronic main-tenance antiplatelet monotherapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Methods and Results: Overall, 5,112 patients were stratified (in kg/m2) into underweight (BMI <= 18.4), normal weight (18.5-22.9), overweight (23.0-24.9), obesity (25.0-29.9) and severe obesity (>= 30.0) categories with randomized antiplatelet monotherapy of aspirin 100 mg or clopidogrel 75 mg once daily for 24 months. The primary endpoint was the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome and major bleeding of Bleeding Academic Research Consortium type >= 3. Compared with normal weight, the risk of primary composite outcomes was higher in the underweight (hazard ratio [HR] 2.183 [1.199-3.974]), but lower in the obesity (HR 0.730 [0.558-0.954]) and severe obesity (HR 0.518 [0.278-0.966]) categories, which is partly driven by the difference in all-cause death. The risk of major bleeding was significantly higher in the underweight (HR 4.140 [1.704-10.059]) than in the normal weight category. A decrease in categorical BMI was independently asso-ciated with the increased risk of primary composite outcomes.Conclusions: Lower BMI is associated with a higher risk of primary composite outcomes, which is primarily related to the events of all-cause death or major bleeding during chronic maintenance antiplatelet monotherapy after PCI with DES.
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