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Body Mass Index and Late Adverse Outcomes after a Carotid Endarterectomy

Danka Vukašinović1, Miloš Maksimović1, Slobodan Tanasković2,3

  • 1Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

International Journal of Environmental Research and Public Health
|February 11, 2023
PubMed

Insights

This study found no link between higher body mass index (BMI) and adverse outcomes after carotid endarterectomy (CEA). Overweight and obese patients experienced similar rates of major adverse outcomes and restenosis compared to normal-weight individuals.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Research
  • Obesity Medicine

Background:

  • Carotid endarterectomy (CEA) is a procedure to prevent stroke.
  • The impact of elevated body mass index (BMI) on long-term outcomes following CEA remains incompletely understood.
  • Obesity is a growing public health concern with potential implications for surgical outcomes.

Purpose of the Study:

  • To investigate the association between increased body mass index (BMI) and late adverse outcomes after carotid endarterectomy (CEA).
  • To compare the incidence of major adverse outcomes (MAOs) and restenosis in overweight and obese patients versus normal-weight patients undergoing CEA.

Main Methods:

  • A cohort study involving 1597 CEAs performed between 2012 and 2017.
  • Four-year follow-up data on myocardial infarction, stroke, death, and restenosis were collected.
  • Logistic and Cox regression analyses were employed to assess the relationship between BMI categories and adverse events.

Main Results:

  • Out of 1223 CEAs with available outcome data, 33.8% were in normal-weight, 47.7% in overweight, and 18.0% in obese patients.
  • No significant differences were observed in the frequency of myocardial infarction, stroke, death (MAOs), or restenosis between BMI groups.
  • BMI was not identified as a predictor for late MAOs or restenosis in regression analyses.

Conclusions:

  • Increased body mass index (BMI), including overweight and obesity, is not associated with an increased risk of late adverse outcomes after carotid endarterectomy (CEA).
  • These findings suggest that elevated BMI may not be a contraindication for CEA regarding long-term safety and efficacy.
  • Further research could explore other factors influencing outcomes in obese patients undergoing CEA.

Keywords:
body mass indexcarotid endarterectomylate outcomesobesityoverweight

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