Body Mass Index and Major Adverse Events During Chronic Antiplatelet Monotherapy After Percutaneous Coronary Intervention With Drug-Eluting Stents　― Results From the HOST-EXAM Trial ―

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  • Won Ki-Bum
    Division of Cardiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine
  • Shin Eun-Seok
    Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine
  • Kang Jeehoon
    Division of Cardiology, Seoul National University Hospital
  • Yang Han-Mo
    Division of Cardiology, Seoul National University Hospital
  • Park Kyung Woo
    Division of Cardiology, Seoul National University Hospital
  • Han Kyoo-Rok
    Division of Cardiology, Kangdong Sacred Heart Hospital, Hallym University
  • Moon Keon-Woong
    Division of Cardiology, St. Vincent’s Hospital, The Catholic University of Korea
  • Oh Seok Kyu
    Division of Cardiology, Wonkwang University Hospital
  • Kim Ung
    Division of Cardiology, Yeungnam University Hospital
  • Rhee Moo-Yong
    Division of Cardiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine
  • Kim Doo-Il
    Division of Cardiology, Haeundae Paik Hospital, Inje University
  • Kim Song-Yi
    Division of Cardiology, College of Medicine, Jeju National University
  • Lee Sung-Yun
    Division of Cardiology, Ilsan Paik Hospital, Inje University
  • Han Jung-Kyu
    Division of Cardiology, Seoul National University Hospital
  • Koo Bon-Kwon
    Division of Cardiology, Seoul National University Hospital
  • Kim Hyo-Soo
    Division of Cardiology, Seoul National University Hospital

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<p>Background: This study evaluated the association of body mass index (BMI) with adverse clinical outcomes during chronic maintenance antiplatelet monotherapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).</p><p>Methods and Results: Overall, 5,112 patients were stratified (in kg/m2) into underweight (BMI ≤18.4), normal weight (18.5–22.9), overweight (23.0–24.9), obesity (25.0–29.9) and severe obesity (≥30.0) categories with randomized antiplatelet monotherapy of aspirin 100 mg or clopidogrel 75 mg once daily for 24 months. The primary endpoint was the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome and major bleeding of Bleeding Academic Research Consortium type ≥3. Compared with normal weight, the risk of primary composite outcomes was higher in the underweight (hazard ratio [HR] 2.183 [1.199–3.974]), but lower in the obesity (HR 0.730 [0.558–0.954]) and severe obesity (HR 0.518 [0.278–0.966]) categories, which is partly driven by the difference in all-cause death. The risk of major bleeding was significantly higher in the underweight (HR 4.140 [1.704–10.059]) than in the normal weight category. A decrease in categorical BMI was independently associated with the increased risk of primary composite outcomes.</p><p>Conclusions: Lower BMI is associated with a higher risk of primary composite outcomes, which is primarily related to the events of all-cause death or major bleeding during chronic maintenance antiplatelet monotherapy after PCI with DES.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 87 (2), 268-276, 2023-01-25

    一般社団法人 日本循環器学会

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