超导管大动脉置换中的肥胖悖论
Luai Madanat1, Ahmad Jabri2, Ivan D Hanson1
1William Beaumont University Hospital, Corewell Health East, Royal Oak, MI, USA.
Current cardiology reports
|July 29, 2024
概括
患有肥胖症的患者在经过透气管大动脉置换 (TAVR) 后的生存率更好. 下肢体质量指数 (BMI) 范围与TAVR手术后死亡风险增加有关.
科学领域:
- 心脏病学 心脏病学
- 临床结果 临床结果
- 干预心脏病学 干预心脏病学
背景情况:
- 肥胖悖论,即增加的体重指数 (BMI) 与在某些条件下更好的结果相关,在心血管疾病中越来越被认可.
- 了解BMI和死亡率在透管大动脉置换后 (TAVR) 之间的关系对于风险分层至关重要.
研究的目的:
- 调查BMI对接受TAVR治疗严重大动脉狭窄症患者的死亡率的影响.
- 确定肥胖悖论是否适用于TAVR后的结果.
主要方法:
- 一个多中心的回顾性分析包括6688名患有严重大动脉狭窄的患者接受TAVR.
- 患者被分为体重不足 (BMI <18.5),正常体重 (18.524.9),超重 (2529.9) 和肥胖 (BMI ≥30) 的类别.
- 用多变量考克斯比例危险模型分析了全因死亡率.
主要成果:
- 肥胖患者 (BMI ≥30) 与体重不足,体重正常和超重组相比,30天和3年全因死亡率较低.
- 多变量分析证实,与体重不足和体重正常的人相比,肥胖与长期死亡率明显降低有关.
- 在超重和肥胖患者之间没有观察到死亡率的显著差异.
结论:
- 肥胖与TAVR后的短期和长期生存率的改善有关.
- 在TAVR人群中,随着BMI范围的下降,死亡率逐渐增加.
- 这些发现强调了在TAVR患者心血管风险预测的背景下考虑BMI的重要性.
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