Abstract 13542: In-Hospital Outcomes of Percutaneous Coronary Interventions in Extremely Obese and Normal Weight Patients: Findings from NCDR²

Abstract

Background: Extreme obesity (BMI ≥ 40 kg/m²) is becoming more prevalent in the United States. Little is known about the outcomes of percutaneous coronary intervention (PCI) in this subgroup. We compared the in-hospital outcomes of PCI in this subgroup with that of the normal weight patients in the CathPCI Registry^®.

Methods: All extremely obese patients who had undergone PCI procedures between Feb 28, 2008 and Jun 30, 2011 via the femoral or radial artery (N= 83,861) were compared with those of normal weight patients (BMI 20-25 kg/m², N= 217,616) in the NCDR. Outcomes included in-hospital mortality, procedural and bleeding complications. Multivariable logistic regression models were used to assess the independent association of extreme obesity with outcomes, using previously validated risk models derived from NCDR.

Results: Compared with normal weight patients, extremely obese patients had a lower median age (60 vs. 69 years old), were more likely to be female (47% vs. 37%), and African Americans comprised a larger proportion of this group (12% vs. 7%). This group had lower mortality (1.2% vs. 2.0%), however, after multivariable adjustment, extreme obesity was independently associated with increased risk of in-hospital mortality (OR = 1.14, P= 0.005), despite decreased risk of bleeding (OR = 0.80, P <.001) (Figure). The interaction of femoral (vs. radial) access with extreme obesity on outcomes was not statistically significant.

Conclusions: Extremely obese patients who underwent PCI were younger and had less bleeding as compared with normal weight patients. Despite this, after multivariable adjustment for risk, extreme obesity was independently associated with higher in-hospital mortality.