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- Document type:
- Journal Article; Multicenter Study; Randomized Controlled Trial; Article
- Author(s):
- Volkers, Eline J; Greving, Jacoba P; Hendrikse, Jeroen; Algra, Ale; Kappelle, L Jaap; Becquemin, Jean-Pierre; Bonati, Leo H; Brott, Thomas G; Bulbulia, Richard; Calvet, David; Eckstein, Hans-Henning; Fraedrich, Gustav; Gregson, John; Halliday, Alison; Howard, George; Jansen, Olav; Roubin, Gary S; Brown, Martin M; Mas, Jean-Louis; Ringleb, Peter A
- Title:
- Body mass index and outcome after revascularization for symptomatic carotid artery stenosis.
- Abstract:
- To determine whether the obesity paradox exists in patients who undergo carotid artery stenting (CAS) or carotid endarterectomy (CEA) for symptomatic carotid artery stenosis.We combined individual patient data from 2 randomized trials (Endarterectomy vs Angioplasty in Patients with Symptomatic Severe Carotid Stenosis and Stent-Protected Angioplasty vs Carotid Endarterectomy) and 3 centers in a third trial (International Carotid Stenting Study). Baseline body mass index (BMI) was available for 1,969 patients and classified into 4 groups: <20, 20-<25, 25-<30, and >=30 kg/m(2). 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.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) or 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).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.
- Journal title abbreviation:
- Neurology
- Year:
- 2017
- Journal volume:
- 88
- Journal issue:
- 21
- Pages contribution:
- 2052-2060
- Language:
- eng
- Fulltext / DOI:
- doi:10.1212/WNL.0000000000003957
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/28446644
- Print-ISSN:
- 0028-3878
- TUM Institution:
- Fachgebiet Gefäßchirurgie (Prof. Eckstein)
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