Body mass index and outcome after revascularization for symptomatic carotid artery stenosis.

EJ Volkers; JP Greving; J Hendrikse; A Algra; LJ Kappelle; JP Becquemin; LH Bonati; TG Brott; R Bulbulia; D Calvet; +30 more... HH Eckstein; G Fraedrich; J Gregson; A Halliday; G Howard; O Jansen; GS Roubin; MM Brown; JL Mas; PA Ringleb; Carotid Stenosis Trialists' Collaboration; COLLABORATORS ; AProf Algra; JPProf Becquemin; D Calvet; JLProf Mas; LH Bonati; MMProf Brown; JProf Hendrikse; HHProf Eckstein; GProf Fraedrich; OProf Jansen; PAProf Ringleb; TGProf Brott; GProf Howard; GSProf Roubin; R Bulbulia; A Halliday; J Radcliffe; J Gregson; (2017) Body mass index and outcome after revascularization for symptomatic carotid artery stenosis. Neurology. ISSN 0028-3878 DOI: 10.1212/WNL.0000000000003957
Copy

To determine whether the obesity paradox exists in patients who undergo carotid artery stenting (CAS) or carotid endarterectomy (CEA) for symptomatic carotid artery stenosis.

We combined individual patient data from 2 randomized trials (Endarterectomy vs Angioplasty in Patients with Symptomatic Severe Carotid Stenosis and Stent-Protected Angioplasty vs Carotid Endarterectomy) and 3 centers in a third trial (International Carotid Stenting Study). Baseline body mass index (BMI) was available for 1,969 patients and classified into 4 groups: <20, 20-<25, 25-<30, and ≥30 kg/m(2). Primary outcome was stroke or death, investigated separately for the periprocedural and postprocedural period (≤120 days/>120 days after randomization). This outcome was compared between different BMI strata in CAS and CEA patients separately, and in the total group. We performed intention-to-treat multivariable Cox regression analyses.

Median follow-up was 2.0 years. Stroke or death occurred in 159 patients in the periprocedural (cumulative risk 8.1%) and in 270 patients in the postprocedural period (rate 4.8/100 person-years). BMI did not affect periprocedural risk of stroke or death for patients assigned to CAS (ptrend = 0.39) or CEA (ptrend = 0.77) or for the total group (ptrend = 0.48). Within the total group, patients with BMI 25-<30 had lower postprocedural risk of stroke or death than patients with BMI 20-<25 (BMI 25-<30 vs BMI 20-<25; hazard ratio 0.72; 95% confidence interval 0.55-0.94).

BMI is not associated with periprocedural risk of stroke or death; however, BMI 25-<30 is associated with lower postprocedural risk than BMI 20-<25. These observations were similar for CAS and CEA.


['material/summary:fileicon_binary/octet-stream' not defined]
Body mass index and outcome after_GREEN VoR.pdf
subject
Accepted Version
Available under Creative Commons: NC-ND 3.0

Download

Atom BibTeX OpenURL ContextObject in Span Multiline CSV OpenURL ContextObject Dublin Core Dublin Core MPEG-21 DIDL EndNote HTML Citation JSON MARC (ASCII) MARC (ISO 2709) METS MODS RDF+N3 RDF+N-Triples RDF+XML RIOXX2 XML Reference Manager Refer Simple Metadata ASCII Citation EP3 XML
Export

Downloads