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Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery

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Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery. / Hidvegi, Reka; Puelacher, Christian; Gualandro, Danielle M; Lampart, Andreas; Lurati Buse, Giovanna; Hammerer-Lerchner, Angelika; Walter, Joan; Liffert, Marcel; Bolliger, Daniel; Steiner, Luzius; Kindler, Christoph; Espinola, Jaqueline; Strebel, Ivo; Gueckel, Johanna; Marbot, Stella; Arslani, Ketina; Boeddinghaus, Jasper; Nestelberger, Thomas; Zimmermann, Tobias; Freese, Michael; Guerke, Lorenz; Mujagic, Edin; Rikli, Daniel; Buser, Andreas; Mueller, Christian; BASEL-P.M.I. Investigators.

in: CLIN RES CARDIOL, Jahrgang 109, Nr. 9, 09.2020, S. 1140-1147.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Hidvegi, R, Puelacher, C, Gualandro, DM, Lampart, A, Lurati Buse, G, Hammerer-Lerchner, A, Walter, J, Liffert, M, Bolliger, D, Steiner, L, Kindler, C, Espinola, J, Strebel, I, Gueckel, J, Marbot, S, Arslani, K, Boeddinghaus, J, Nestelberger, T, Zimmermann, T, Freese, M, Guerke, L, Mujagic, E, Rikli, D, Buser, A, Mueller, C & BASEL-P.M.I. Investigators 2020, 'Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery', CLIN RES CARDIOL, Jg. 109, Nr. 9, S. 1140-1147. https://doi.org/10.1007/s00392-020-01605-0

APA

Hidvegi, R., Puelacher, C., Gualandro, D. M., Lampart, A., Lurati Buse, G., Hammerer-Lerchner, A., Walter, J., Liffert, M., Bolliger, D., Steiner, L., Kindler, C., Espinola, J., Strebel, I., Gueckel, J., Marbot, S., Arslani, K., Boeddinghaus, J., Nestelberger, T., Zimmermann, T., ... BASEL-P.M.I. Investigators (2020). Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery. CLIN RES CARDIOL, 109(9), 1140-1147. https://doi.org/10.1007/s00392-020-01605-0

Vancouver

Hidvegi R, Puelacher C, Gualandro DM, Lampart A, Lurati Buse G, Hammerer-Lerchner A et al. Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery. CLIN RES CARDIOL. 2020 Sep;109(9):1140-1147. https://doi.org/10.1007/s00392-020-01605-0

Bibtex

@article{1c7c4e51786142c4a6c9ad3ab453522f,
title = "Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery",
abstract = "BACKGROUND: The impact of obesity on the incidence of perioperative myocardial infarction/injury (PMI) and mortality following non-cardiac surgery is not well understood.METHODS: We performed a prospective diagnostic study enrolling consecutive patients undergoing non-cardiac surgery, who were considered at increased cardiovascular risk. All patients were screened for PMI, defined as an absolute increase from preoperative to postoperative sensitive/high-sensitivity cardiac troponin T (hs-cTnT) concentrations. The body mass index (BMI) was classified according to the WHO classification (underweight< 18 kg/m2, normal weight 18-24.9 kg/m2, overweight 25-29.9 kg/m2, obesity class I 30-34.9 kg/m2, obesity class II 35-39.9 kg/m2, obesity class III > 40 kg/m2). The incidence of PMI and all-cause mortality at 365 days, both stratified according to BMI.RESULTS: We enrolled 4277 patients who had undergone 5413 surgeries. The median BMI was 26 kg/m2 (interquartile range 23-30 kg/m2). Incidence of PMI showed a non-linear relationship with BMI and ranged from 12% (95% CI 9-14%) in obesity class I to 19% (95% CI 17-42%) in the underweight group. This was confirmed in multivariable analysis with obesity class I. showing the lowest risk (adjusted OR 0.64; 95% CI 0.49-0.83) for developing PMI. Mortality at 365 days was lower in all obesity groups compared to patients with normal body weight (e.g., unadjusted OR 0.54 (95% CI 0.39-0.73) and adjusted OR 0.52 (95% CI 0.38-0.71) in obesity class I).CONCLUSION: Obesity class I was associated with a lower incidence of PMI, and obesity in general was associated with a lower all-cause mortality at 365 days.",
keywords = "Aged, Aged, 80 and over, Body Mass Index, Female, Follow-Up Studies, Heart Disease Risk Factors, Humans, Ideal Body Weight, Incidence, Male, Myocardial Infarction/epidemiology, Obesity/complications, Overweight/complications, Postoperative Complications/epidemiology, Prospective Studies, Risk Factors, Thinness/complications",
author = "Reka Hidvegi and Christian Puelacher and Gualandro, {Danielle M} and Andreas Lampart and {Lurati Buse}, Giovanna and Angelika Hammerer-Lerchner and Joan Walter and Marcel Liffert and Daniel Bolliger and Luzius Steiner and Christoph Kindler and Jaqueline Espinola and Ivo Strebel and Johanna Gueckel and Stella Marbot and Ketina Arslani and Jasper Boeddinghaus and Thomas Nestelberger and Tobias Zimmermann and Michael Freese and Lorenz Guerke and Edin Mujagic and Daniel Rikli and Andreas Buser and Christian Mueller and {BASEL-P.M.I. Investigators} and Raphael Twerenbold",
year = "2020",
month = sep,
doi = "10.1007/s00392-020-01605-0",
language = "English",
volume = "109",
pages = "1140--1147",
journal = "CLIN RES CARDIOL",
issn = "1861-0684",
publisher = "D. Steinkopff-Verlag",
number = "9",

}

RIS

TY - JOUR

T1 - Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery

AU - Hidvegi, Reka

AU - Puelacher, Christian

AU - Gualandro, Danielle M

AU - Lampart, Andreas

AU - Lurati Buse, Giovanna

AU - Hammerer-Lerchner, Angelika

AU - Walter, Joan

AU - Liffert, Marcel

AU - Bolliger, Daniel

AU - Steiner, Luzius

AU - Kindler, Christoph

AU - Espinola, Jaqueline

AU - Strebel, Ivo

AU - Gueckel, Johanna

AU - Marbot, Stella

AU - Arslani, Ketina

AU - Boeddinghaus, Jasper

AU - Nestelberger, Thomas

AU - Zimmermann, Tobias

AU - Freese, Michael

AU - Guerke, Lorenz

AU - Mujagic, Edin

AU - Rikli, Daniel

AU - Buser, Andreas

AU - Mueller, Christian

AU - BASEL-P.M.I. Investigators

AU - Twerenbold, Raphael

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND: The impact of obesity on the incidence of perioperative myocardial infarction/injury (PMI) and mortality following non-cardiac surgery is not well understood.METHODS: We performed a prospective diagnostic study enrolling consecutive patients undergoing non-cardiac surgery, who were considered at increased cardiovascular risk. All patients were screened for PMI, defined as an absolute increase from preoperative to postoperative sensitive/high-sensitivity cardiac troponin T (hs-cTnT) concentrations. The body mass index (BMI) was classified according to the WHO classification (underweight< 18 kg/m2, normal weight 18-24.9 kg/m2, overweight 25-29.9 kg/m2, obesity class I 30-34.9 kg/m2, obesity class II 35-39.9 kg/m2, obesity class III > 40 kg/m2). The incidence of PMI and all-cause mortality at 365 days, both stratified according to BMI.RESULTS: We enrolled 4277 patients who had undergone 5413 surgeries. The median BMI was 26 kg/m2 (interquartile range 23-30 kg/m2). Incidence of PMI showed a non-linear relationship with BMI and ranged from 12% (95% CI 9-14%) in obesity class I to 19% (95% CI 17-42%) in the underweight group. This was confirmed in multivariable analysis with obesity class I. showing the lowest risk (adjusted OR 0.64; 95% CI 0.49-0.83) for developing PMI. Mortality at 365 days was lower in all obesity groups compared to patients with normal body weight (e.g., unadjusted OR 0.54 (95% CI 0.39-0.73) and adjusted OR 0.52 (95% CI 0.38-0.71) in obesity class I).CONCLUSION: Obesity class I was associated with a lower incidence of PMI, and obesity in general was associated with a lower all-cause mortality at 365 days.

AB - BACKGROUND: The impact of obesity on the incidence of perioperative myocardial infarction/injury (PMI) and mortality following non-cardiac surgery is not well understood.METHODS: We performed a prospective diagnostic study enrolling consecutive patients undergoing non-cardiac surgery, who were considered at increased cardiovascular risk. All patients were screened for PMI, defined as an absolute increase from preoperative to postoperative sensitive/high-sensitivity cardiac troponin T (hs-cTnT) concentrations. The body mass index (BMI) was classified according to the WHO classification (underweight< 18 kg/m2, normal weight 18-24.9 kg/m2, overweight 25-29.9 kg/m2, obesity class I 30-34.9 kg/m2, obesity class II 35-39.9 kg/m2, obesity class III > 40 kg/m2). The incidence of PMI and all-cause mortality at 365 days, both stratified according to BMI.RESULTS: We enrolled 4277 patients who had undergone 5413 surgeries. The median BMI was 26 kg/m2 (interquartile range 23-30 kg/m2). Incidence of PMI showed a non-linear relationship with BMI and ranged from 12% (95% CI 9-14%) in obesity class I to 19% (95% CI 17-42%) in the underweight group. This was confirmed in multivariable analysis with obesity class I. showing the lowest risk (adjusted OR 0.64; 95% CI 0.49-0.83) for developing PMI. Mortality at 365 days was lower in all obesity groups compared to patients with normal body weight (e.g., unadjusted OR 0.54 (95% CI 0.39-0.73) and adjusted OR 0.52 (95% CI 0.38-0.71) in obesity class I).CONCLUSION: Obesity class I was associated with a lower incidence of PMI, and obesity in general was associated with a lower all-cause mortality at 365 days.

KW - Aged

KW - Aged, 80 and over

KW - Body Mass Index

KW - Female

KW - Follow-Up Studies

KW - Heart Disease Risk Factors

KW - Humans

KW - Ideal Body Weight

KW - Incidence

KW - Male

KW - Myocardial Infarction/epidemiology

KW - Obesity/complications

KW - Overweight/complications

KW - Postoperative Complications/epidemiology

KW - Prospective Studies

KW - Risk Factors

KW - Thinness/complications

U2 - 10.1007/s00392-020-01605-0

DO - 10.1007/s00392-020-01605-0

M3 - SCORING: Journal article

C2 - 32025837

VL - 109

SP - 1140

EP - 1147

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 9

ER -