MedStar Authors catalog › Details for: Body mass index association with survival in severe aortic stenosis patients undergoing transcatheter aortic valve replacement.
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Body mass index association with survival in severe aortic stenosis patients undergoing transcatheter aortic valve replacement.

by Koifman, Edward; Kiramijyan, Starkis; Negi, Smita I; Didier, Romain; Escarcega, Ricardo O; Minha, Sa'ar; Gai, Jiaxing; Torguson, Rebecca; Okubagzi, Petros; Ben-Dor, Itsik; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron.
Citation: Catheterization & Cardiovascular Interventions. 88(1):118-24, 2016 Jul.Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.Published: 2016ISSN: 1522-1946.Full author list: Koifman E; Kiramijyan S; Negi SI; Didier R; Escarcega RO; Minha S; Gai J; Torguson R; Okubagzi P; Ben-Dor I; Satler LF; Pichard AD; Waksman R.UI/PMID: 26715505.Subject(s): Aged | Aged, 80 and over | Aortic Valve/dg [Diagnostic Imaging] | Aortic Valve/pp [Physiopathology] | *Aortic Valve | Aortic Valve Stenosis/co [Complications] | Aortic Valve Stenosis/dg [Diagnostic Imaging] | Aortic Valve Stenosis/mo [Mortality] | *Aortic Valve Stenosis/th [Therapy] | *Body Mass Index | Cardiac Catheterization/ae [Adverse Effects] | Cardiac Catheterization/mo [Mortality] | *Cardiac Catheterization | Catheterization, Peripheral | Chi-Square Distribution | District of Columbia | Female | Femoral Artery | Frail Elderly | Geriatric Assessment | Heart Valve Prosthesis Implantation/ae [Adverse Effects] | Heart Valve Prosthesis Implantation/mo [Mortality] | *Heart Valve Prosthesis Implantation | Humans | Kaplan-Meier Estimate | Male | Multivariate Analysis | *Obesity/co [Complications] | Obesity/di [Diagnosis] | Obesity/mo [Mortality] | Proportional Hazards Models | Retrospective Studies | Risk Factors | Severity of Illness Index | Time Factors | Treatment OutcomeInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: Catheter Cardiovasc Interv. 88(1):118-24, 2016 Jul.Local Holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006.Abstract: BACKGROUND: Conflicting results have been reported regarding impact of body mass index (BMI) on outcome of transcatheter aortic valve replacement (TAVR) patients. This study evaluates the impact of BMI on 1 year mortality in patients undergoing TAVR via the transfemoral (TF) access.Abstract: METHODS: Aortic stenosis (AS) patients undergoing TAVR via a TF access between May 2007 and December 2014 were categorized to 4 groups by BMI: low (<20), normal (20-24.9), overweight (25-30), and obese (>30). Baseline parameters were compared, and multivariate Cox proportional hazard regression models were generated to assess outcome differences.Abstract: RESULTS: Among 491 severe AS TAVR patients, 43 had low BMI, 148 had normal BMI, 162 were overweight, and 138 were obese. Obese patients were younger with lower Society of Thoracic Surgeons scores and higher rates of preserved ejection fraction and diabetes. There was a higher rate of women in the BMI extremes. Aortic valve area was higher among obese patients; however, the indexed area was inversely correlated with BMI. Vascular complications and transfusions were more common in the low-BMI group, while acute kidney injury was more common in obese patients. All-cause mortality at 1 year was higher in the low-BMI group (log-rank p=0.003) with no significant difference among normal and above-normal BMI patients. In a multivariate model, BMI <20 kg/m(2) was an independent predictor of mortality (HR=2.45, p=0.01).Abstract: CONCLUSIONS: BMI <20 kg/m(2) should be considered a frailty marker during the screening process of severe AS TAVR patients as it is associated with higher mortality, while obesity confers similar mortality risk as normal weight. � 2015 Wiley Periodicals, Inc.Abstract: Copyright � 2015 Wiley Periodicals, Inc.

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