Author + information
- Masieh Abawi1,
- Rik Rozemeijer2,
- Pierfrancesco Agostoni3,
- Michiel Voskuil4,
- Pieter Doevendans4 and
- Pieter Stella4
We sought to determine whether the obesity paradox exists in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) and to explore potential baseline factors that might contribute to it.
Overweight and obesity are associated with a decreased life expectancy and increased early mortality. Counterintuitively, higher body mass index (BMI) is linked to improved survival in certain patients groups. However, scarce data exist on the effect of BMI on the clinical outcomes and all-cause mortality following TAVR.
We performed an analysis to evaluate the association between BMI and the risk of death among 504 consecutive patients undergoing TAVR in our institution. Patients were classified according to World Health Organization criteria as normal weight, overweight, and obese (18.5 to 24.9 kg/m2, 25.0 to 29.9 kg/m2, and 30.0 to 39.9 kg/m2, respectively).
After a median follow-up of 587[interquartile range: 237-1140] days, normal weight patients showed an increased rate of all-cause mortality when compared with overweight and obese groups (36.5% vs. 22.7% and 23.7%, p=0.004). As a continuous variable, BMI was an independent predictor of 1- year all-cause mortality (Hazard Ratio: 0.95; 95% Confidence Interval 0.91-0.99, p=0.034), after adjustment for several possible confounding factors.
After transcatheter aortic valve replacement higher body mass index was associated with improved survival independent of possible confounding factors.
STRUCTURAL: Valvular Disease: Aortic