Abstract
Background:
Low body mass index (BMI) patients (pts) undergoing percutaneous coronary intervention (PCI) are at the highest risk for in-hospital complications and cardiac death when compared to overweight or obese pts (“obesity paradox”). Likewise, chronic kidney disease (CKD) (eGFR <60 mL/min/1.73m
2
) pts are at a higher risk of adverse events following PCI.
Aim:
To assess the impact of BMI on bleeding complications in pts with and without CKD undergoing PCI.
Methods:
Between 12/2010 and 03/2018 a total of 4,400 CKD pts (eGFR <60 mL/min) and 13,197 pts without CKD underwent PCI. Pts were divided into three groups: BMI <24.9 (normal), BMI 25 to 29.9 (overweight), and BMI >30 (obese). Bleeding complications were classified by the Bleeding Academic Research Consortium (BARC). BARC Type 4 (CABG-related) and Type 5 (fatal) bleeding events were excluded. Multiple logistic regression was utilized with p<0.05 significance level.
Results:
Pts were 72% male, mean age 67 and 43% were diabetic. Both BMI category and CKD status were significantly associated with BARC score ≥3 in a multiple logistic regression model (p=0.004, and p<0.0001, respectively). There was no evidence of an interaction between CKD status and BMI and the effect on BARC score (p= 0.08). Among those with CKD, BMI category failed to associate with BARC≥3 status (p=0.1), but among those without CKD, BMI category was significantly associated with BARC ≥3 status (p= 0.003), as shown in Figure. Multivariate logistic regression analysis will be presented.
Conclusion:
In pts undergoing PCI: 1) BMI and CKD status are associated with severe bleeding (BARC≥3) complications; 2) normal BMI, non-CKD patients had a significantly higher rate of severe bleeding complications when compared to overweight or obese patients; and 3) obese CKD patients had a lower rate of severe bleeding complications compared to normal BMI or overweight patients but did not achieve statistical significance.