Abstract 15587: Iimpact of Body Mass Index on Bleeding Events Patients Undergoing Percutaneous Coronary Intervention With or Without High Bleeding Risk

Abstract

Introduction: High body mass index (BMI) values are associated with a lower risk of ischemic complications after percutaneous coronary intervention (PCI). Hypothesis : Higher BMI values may correlate with fewer bleeding after PCI in patients meeting or not the High Bleeding Risk (HBR) criteria of the Academic Research Consortium (ARC). Methods: All patients undergoing PCI between 2012 and 2019 at the Mount Sinai Hospital were included and stratified in 5 BMI categories according to World Health Organization definition. Patients where considered at HBR if they fulfilled ≥1 major or ≥2 minor ARC-HBR criteria. The primary outcome was major bleeding, the secondary outcome was post-discharge major bleeding at 1 year after PCI. Risks for these outcomes were obtained using a multivariable Cox regression model adjusted for the ARC-HBR criteria. Results: Among 16,229 patients, 20.2% had a BMI ≥18.5-25 (normal), 40.7% had a BMI ≥25-30, 24.4% had a BMI ≥30-35, 9.2% had a BMI ≥35-40, and 4.8% had a BMI ≥40 kg/m 2 . The proportion of patients meeting the ARC-HBR criteria progressively decreased from 48% in the normal BMI group to 41% in the highest BMI group. As compared to the normal BMI group (6.0%), the 1-year risk of major bleeding was significantly lower (p<0.05) in the groups with BMI ≥25-30 (4.1%, adj. HR 0.73, 95% CI 0.60-0.88), with BMI ≥30-35 (3.5%, Adj. HR 0.62, 95% CI 0.49-0.77), with BMI ≥35-40 (4.2%; Adj. HR 0.72, 95% CI 0.54-0.9), while it was similar in the group of BMI ≥40 (4.9%, Adj. HR 0.83, 95% CI 0.58-1.18) ( A ). These differences were driven by lower rates of in-hospital bleeding in patients with BMI ≥25-40 kg/m 2 . Among HBR patients, 1-year rates of major bleeding were consistently above 4% in each BMI category, but relatively lower for BMI ≥25-40 kg/m 2 ( B ). Conclusions: BMI values between 25 and 40 kg/m 2 were associated with an attenuated risk of major bleeding at 1-year in patients undergoing PCI and this association was consistent among HBR individuals.