Journal article
Body mass index and outcome after revascularization for symptomatic carotid artery stenosis
- Abstract:
-
Objective: We determined whether the obesity paradox exists in patients who undergo carotid artery stenting (CAS) or carotid endarterectomy (CEA) for symptomatic carotid artery stenosis.
Methods: We combined individual patient data from two randomized trials (EVA-3S and SPACE) and three centers in a third trial (ICSS). Baseline body mass index (BMI) was available for 1,969 patients and classified into four groups: <20, 20-<25, 25-<30, and ≥30 kg/m2. Primary outcome was stroke or death, investigated separately for the periprocedural and postprocedural period (≤120 days/>120 days after randomization). This outcome was compared between different BMI strata in CAS and CEA patients separately, and in the total group. We performed intention-to-treat multivariable Cox regression analyses.
Results: Median follow-up was 2.0 years. Stroke or death occurred in 159 patients in the periprocedural (cumulative risk 8.1%) and in 270 patients in the postprocedural period (rate 4.8/100 person-years). BMI did not affect periprocedural risk of stroke or death for patients assigned to CAS (ptrend=0.39) or CEA (ptrend=0.77), nor for the total group (ptrend=0.48). Within the total group, patients with BMI 25-<30 had lower postprocedural risk of stroke or death than patients with BMI 20-<25 (BMI 25-<30 vs. BMI 20-<25; hazard ratio 0.72; 95% confidence interval 0.55-0.94).
Conclusions: BMI is not associated with periprocedural risk of stroke or death; however, BMI 25-<30 is associated with lower postprocedural risk than BMI 20-<25. These observations were similar for CAS and CEA.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 429.6KB, Terms of use)
-
- Publisher copy:
- 10.1212/WNL.0000000000003957
Authors
- Funding agency for:
- Bonati, L
- Grant:
- PBBSB-116873
- Funding agency for:
- Bonati, L
- Grant:
- PBBSB-116873
- Publisher:
- American Academy of Neurology
- Journal:
- Neurology More from this journal
- Volume:
- 81
- Issue:
- 21
- Pages:
- 2052-2060
- Publication date:
- 2017-04-26
- Acceptance date:
- 2017-03-01
- DOI:
- EISSN:
-
1526-632X
- ISSN:
-
0028-3878
- Pubs id:
-
pubs:683950
- UUID:
-
uuid:0354ee47-98ee-481a-af4b-c6eedfe831d1
- Local pid:
-
pubs:683950
- Source identifiers:
-
683950
- Deposit date:
-
2017-03-03
Terms of use
- Copyright holder:
- © 2017 American Academy of Neurology
- Copyright date:
- 2017
- Notes:
- This is the publisher's version of the article. The final version is available online from American Academy of Neurology at: 10.1212/WNL.0000000000003957
If you are the owner of this record, you can report an update to it here: Report update to this record