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Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery

Hidvegi, Reka and Puelacher, Christian and Gualandro, Danielle M. and Lampart, Andreas and Lurati Buse, Giovanna and Hammerer-Lerchner, Angelika and Walter, Joan and Liffert, Marcel and Bolliger, Daniel and Steiner, Luzius and Kindler, Christoph and Espinola, Jaqueline and Strebel, Ivo and Gueckel, Johanna and Marbot, Stella and Arslani, Ketina and Boeddinghaus, Jasper and Nestelberger, Thomas and Zimmermann, Tobias and Freese, Michael and Guerke, Lorenz and Mujagic, Edin and Rikli, Daniel and Buser, Andreas and Mueller, Christian and Basel-P. M. I. Investigators, . (2020) Obesity paradox and perioperative myocardial infarction/injury in non-cardiac surgery. Clinical Research in Cardiology, 109 (9). pp. 1140-1147.

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Abstract

The impact of obesity on the incidence of perioperative myocardial infarction/injury (PMI) and mortality following non-cardiac surgery is not well understood.; We performed a prospective diagnostic study enrolling consecutive patients undergoing non-cardiac surgery, who were considered at increased cardiovascular risk. All patients were screened for PMI, defined as an absolute increase from preoperative to postoperative sensitive/high-sensitivity cardiac troponin T (hs-cTnT) concentrations. The body mass index (BMI) was classified according to the WHO classification (underweight 40 kg/m; 2; ). The incidence of PMI and all-cause mortality at 365 days, both stratified according to BMI.; We enrolled 4277 patients who had undergone 5413 surgeries. The median BMI was 26 kg/m; 2; (interquartile range 23-30 kg/m; 2; ). Incidence of PMI showed a non-linear relationship with BMI and ranged from 12% (95% CI 9-14%) in obesity class I to 19% (95% CI 17-42%) in the underweight group. This was confirmed in multivariable analysis with obesity class I. showing the lowest risk (adjusted OR 0.64; 95% CI 0.49-0.83) for developing PMI. Mortality at 365 days was lower in all obesity groups compared to patients with normal body weight (e.g., unadjusted OR 0.54 (95% CI 0.39-0.73) and adjusted OR 0.52 (95% CI 0.38-0.71) in obesity class I).; Obesity class I was associated with a lower incidence of PMI, and obesity in general was associated with a lower all-cause mortality at 365 days.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
UniBasel Contributors:Hidvégi, Réka and Puelacher, Christian and Gualandro, Danielle and Müller, Christian
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Springer
ISSN:1861-0684
e-ISSN:1861-0692
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:23 Mar 2022 11:15
Deposited On:23 Mar 2022 11:15

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