Abstract 18054: Does the Presence of Obesity Influence Endothelial Function Favorably in Patients Who Have Undergone Percutaneous Coronary Intervention?
Background: It is well known that obesity is a risk factor for cardiovascular disease. Nevertheless, some studies have shown that in patients who have undergone percutaneous coronary intervention (PCI), obesity has a paradoxically positive impact on prognosis. Several mechanisms have been suggested for this phenomenon; however, it has not been determined whether the endothelial function improves. Therefore, we investigated the relationship between obesity and changes in endothelial function in patients who underwent PCI.
Methods: Two hundred and thirty-two patients (184 men, mean age: 66years) with coronary artery disease (CAD) who underwent successful PCI for stenotic lesions were enrolled. In each patient, the diameter of the brachial artery in response to hyperemic flow (flow-mediated dilatation: FMD) and nitroglycerin spray (NTG) was measured by high resolution ultrasonography prior to PCI and 6 months following PCI. Angiographic restenosis was defined as >50% diameter reduction at the follow-up coronary angiography. According to the body mass index (BMI), the patients were divided into the following 3 groups: Group I (BMI < 25, n = 147), Group II (25 ≤ BMI < 30, n = 74), and Group III (30 ≤ BMI, n = 11).
Results: The frequencies of hypertension (p < 0.05) and diabetes mellitus (p < 0.01) were low and high-density lipoprotein cholesterol concentration (p < 0.01) was high in Group I. The restenosis rate was similar in the 3 groups. The brachial artery diameter, FMD, and NTG-induced dilation at baseline did not differ among the 3 groups. The difference in FMD was smaller in Group I (Group I: −1.1 ± 0.4%, Group II: 1.0 ± 0.5%, Group III: 1.5 ± 1.3%; p < 0.01), while the difference in NTG-induced dilation did not differ significantly among the 3 groups. Multivariate analysis demonstrated that BMI (p < 0.01) was one of the factors influencing the difference in FMD, independent of the baseline FMD.
Conclusions: These results suggest that obesity was associated positively with the change in FMD in patients who underwent PCI. The improvement in endothelial function may, in part, account for the obesity paradox in such patients.
- © 2010 by American Heart Association, Inc.