Abstract 11771: Impact of Overweight/Obesity/Higher Body Mass Index on Long-Term Major Adverse Cardiac Outcomes Following Chronic Total Occlusion-Percutaneous Coronary Interventions- A Systematic Review and Meta-Analysis

Abstract

Background: Obesity is usually associated with worse cardiovascular outcomes. However, fewer studies have evaluated its impact on long-term major adverse cardiovascular events (MACE) following CTO PCI. We conducted a meta-analysis to assess the same. Methods: PUBMED, Scopus, and EMBASE were systematically searched for studies reporting long-term (at least >1 year) outcomes with obesity vs no obesity in patients with CTO PCI. MACE events [all-cause mortality, cardiac mortality, revascularization, restenosis/reocclusion, recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) were the primary endpoint. Pooled odds ratios (OR) and heterogeneity were assessed with random-effects models and I2 statistics respectively. Subgroup analysis was performed to assess the risk by age group and follow-up duration. The leave-one-study-out method was used for sensitivity analysis. Results: After an initial electronic search of thirty-two studies, five studies were selected, and between 2016 to 2021 selected were included in the final analysis. The sample size consisted of 5022 patients with a median age of 63. No significant impact of higher BMI/obesity was seen overall on a median duration of 2.6 yrs [OR(95% CI)= 0.95 (0.82-1.11), p=0.53, I 2 = 90.86%)] (Fig 1). However, on a subgroup analysis, the geriatric age group (≥65 yrs) demonstrated an "Obesity Paradox" effect on MACE after CTO PCI, [OR (95%CI)=0.64 (0.47-0.88), I 2= 42.13, p<0.01]. There was no difference in a subgroup analysis based on follow-up duration (≥3 years [OR (95%CI)=0.73 (0.42-1.27)] vs <3 years OR (95%CI)=1.04 (0.84-1.27)]. Conclusions: Although higher BMI/obesity was not associated with overall long-term MACE in CTO PCI, the subgroup analysis demonstrated the "Obesity Paradox" (protective) effect in studies with a predominantly geriatric population.