Association of body mass index on 10-year outcomes in patients treated with percutaneous coronary intervention and drug-eluting stents (the DECADE cooperation) - Scorecard - MDSpire
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Association of body mass index on 10-year outcomes in patients treated with percutaneous coronary intervention and drug-eluting stents (the DECADE cooperation)
Clinical Scorecard: Impact of Body Mass Index on Decadal Outcomes in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents: Findings from the DECADE Collaboration
At a Glance
Category
Detail
Condition
Coronary artery disease treated with percutaneous coronary intervention (PCI) using drug-eluting stents (DES)
Key Mechanisms
Body mass index (BMI) influences long-term mortality, cardiovascular death, stent thrombosis, and repeat revascularization outcomes after PCI with DES
Target Population
Patients undergoing PCI with DES implantation, categorized by BMI (underweight, normal-weight, overweight, obese)
Care Setting
Cardiology interventional units and long-term secondary prevention clinics
Key Highlights
10-year all-cause mortality was highest in underweight patients and lowest in overweight patients after PCI with DES.
Overweight and obese patients had increased risk of definite stent thrombosis within 30 days post-PCI.
Obese patients had a lower risk of repeat revascularization compared to normal-weight patients.
Guideline-Based Recommendations
Diagnosis
Assess baseline BMI in patients undergoing PCI with DES to stratify long-term risk.
Management
Consider BMI category in tailoring secondary prevention strategies post-PCI.
Monitor overweight and obese patients closely for early stent thrombosis.
Monitoring & Follow-up
Long-term follow-up (up to 10 years) for mortality and cardiovascular events according to BMI category.
Early surveillance for stent thrombosis within 30 days in overweight and obese patients.
Risks
Underweight patients have increased long-term mortality risk post-PCI.
Overweight and obese patients have higher early stent thrombosis risk.
Obese patients have reduced risk of repeat revascularization.
Patient & Prescribing Data
9486 patients from five randomized trials undergoing PCI with DES, categorized by BMI
BMI influences long-term outcomes; overweight status associated with lower mortality, while underweight status is linked to higher mortality; obese patients show mixed risk profiles including higher early stent thrombosis but lower repeat revascularization.
Clinical Best Practices
Incorporate BMI measurement as a routine part of pre-PCI assessment.
Recognize the U-shaped relationship between BMI and mortality to inform risk stratification.
by Maria Scalamogna, Fiorenzo Simonetti, John Joseph Coughlan, Luis Ortega-Paz, Lorenz Räber, Lisette Okkels Jensen, Michael Maeng, Salvatore Brugaletta, Sebastian Kufner, Sarah Bär, Karl-Ludwig Laugwitz, Dik Heg, Manel Sabaté, Stephan Windecker, Kevin Kris Warnakula Olesen, Adnan Kastrati, Salvatore Cassese
