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
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- Shin Eun-Seok
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine
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- Kang Jeehoon
- Division of Cardiology, Seoul National University Hospital
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- Yang Han-Mo
- Division of Cardiology, Seoul National University Hospital
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- Park Kyung Woo
- Division of Cardiology, Seoul National University Hospital
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- Han Kyoo-Rok
- Division of Cardiology, Kangdong Sacred Heart Hospital, Hallym University
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- Moon Keon-Woong
- Division of Cardiology, St. Vincent’s Hospital, The Catholic University of Korea
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- Oh Seok Kyu
- Division of Cardiology, Wonkwang University Hospital
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- Kim Ung
- Division of Cardiology, Yeungnam University Hospital
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- Rhee Moo-Yong
- Division of Cardiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine
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- Kim Doo-Il
- Division of Cardiology, Haeundae Paik Hospital, Inje University
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- Kim Song-Yi
- Division of Cardiology, College of Medicine, Jeju National University
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- Lee Sung-Yun
- Division of Cardiology, Ilsan Paik Hospital, Inje University
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- Han Jung-Kyu
- Division of Cardiology, Seoul National University Hospital
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- Koo Bon-Kwon
- Division of Cardiology, Seoul National University Hospital
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- Kim Hyo-Soo
- Division of Cardiology, Seoul National University Hospital
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Abstract
<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>
Journal
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- Circulation Journal
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Circulation Journal 87 (2), 268-276, 2023-01-25
The Japanese Circulation Society
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Details 詳細情報について
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- CRID
- 1390013408148439808
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- NII Book ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL BIB ID
- 032636320
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- PubMed
- 36123011
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- Text Lang
- en
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
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- Abstract License Flag
- Disallowed