Author + information
- Received November 20, 2012
- Revision received May 31, 2013
- Accepted June 3, 2013
- Published online August 20, 2013.
- Michael E. Buschur, MD∗,
- Dean Smith, PhD, MPH∗,
- David Share, MD†,
- William Campbell, MD‡,
- Stephen Mattichak, MD§,
- Manoj Sharma, MD⋮ and
- Hitinder S. Gurm, MD∗∗ ()
- ∗Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan
- †Blue Cross Blue Shield of Michigan, Detroit, Michigan
- ‡Borgess Medical Center, Kalamazoo, Michigan
- §Bay Regional Heart and Vascular, Bay City, Michigan
- ⋮Division of Cardiovascular Medicine, Covenant Healthcare, Saginaw, Michigan
Reprint requests and correspondence:
Dr. Hitinder S. Gurm, Department of Medicine, Division of Cardiovascular Medicine, University of Michigan Cardiovascular Center, 2A394, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-5853.
Objectives This study sought to examine the prevalence and clinical implications of morbid obesity among patients undergoing percutaneous coronary intervention (PCI).
Background The prevalence of obesity, and morbid obesity in particular, continues to rise rapidly in the United States. Obese patients are at increased risk for cardiac disease and are more likely to need invasive cardiac procedures. There is a paucity of contemporary data on the prevalence and clinical implications of morbid obesity among patients undergoing PCI.
Methods We examined the prevalence of morbid obesity (body mass index [BMI] ≥40 kg/m2) among 227,044 patients undergoing PCI and enrolled in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium registry from 1998 to 2009.
Results The proportion of morbidly obese patients undergoing PCI increased from 4.38% in 1998 to 8.36% in 2009. Compared with overweight patients (BMI 25 to 30 kg/m2), these patients had significantly increased vascular complications (adjusted odds ratio [OR]: 1.31; 95% CI: 1.17 to 1.47; p < 0.0001), contrast-induced nephropathy (adjusted OR: 1.89; 95% CI: 1.70 to 2.11; p < 0.0001), nephropathy requiring dialysis (adjusted OR: 4.08; 95% CI: 2.98 to 5.59; p < 0.0001), and mortality (adjusted OR: 1.63; 95% CI: 1.33 to 2.00; p < 0.0001).
Conclusions Morbid obesity is increasing in prevalence among patients undergoing PCI and is associated with a higher risk of mortality and morbidity. These epidemiological changes have important implications for technical considerations of cardiac catheterization, design of the catheterization lab to accommodate these patients, and most importantly, for societal effort toward prevention of obesity.
The Blue Cross Blue Shield of Michigan Cardiovascular Consortium registry is funded by Blue Cross Blue Shield of Michigan. The sponsor had no role in analysis, study design, or decision to publish these results. Dr. Gurm received research funding from Agency for Health Care Research and Quality and the National Institutes of Health. Dr. Share is employed by Blue Cross Blue Shield of Michigan. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 20, 2012.
- Revision received May 31, 2013.
- Accepted June 3, 2013.
- American College of Cardiology Foundation