Is body mass index a risk factor for isolated off-pump coronary revascularization?

Castigliano M. Bhamidipati, Keri A. Seymour, Noah Cohen, Roberta Rolland, Karikehalli A. Dilip, Charles J. Lutz

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objective: The influence of body mass index (BMI) as a risk factor for isolated off-pump coronary artery bypass (OPCAB) surgery is unknown. We postulated that BMI ≥ 30 kg/m 2 would adversely affect outcomes following OPCAB at our institution. Methods: From 2002 to 2009, we selected 742 patients (primary, N = 709 [95.6%], re-operative, N = 33 [4.45%]) who underwent isolated OPCAB for analysis. Patients were stratified into groups by BMI: non-obese (BMI < 30 kg/m 2) and obese (BMI ≥ 30 kg/m 2). Preoperative risk, operative characteristics, and postoperative outcomes were analyzed. Risk-adjusted models evaluated the occurrence of any complication and mortality. Results: Overall crude mortality was 1.5% (11/742). When compared to non-obese (26.12 ± 2.72 kg/m 2) recipients, the obese (35.81 ± 5.69 kg/m 2) comprised younger patients (62.46 ± 9.96 years, p < 0.001). Number of diseased vessels, Left ventricular ejection fraction, and baseline renal function was equivalent across groups. Diabetes (53.24%) and hypertension (90.59%) were more prevalent among obese patients (p < 0.001, respectively). Internal mammary artery utilization (p = 0.47), endoscopic vein harvest (p = 0.74), and intra-aortic balloon pump use (p = 0.58) were similar between groups. Interestingly, postoperative blood product requirement was lower in obese versus non-obese recipients (47.35% vs. 56.72%, p < 0.01). Furthermore, intensive care unit stay (p = 0.93), mortality (p = 0.56), and discharge to home (p = 0.09) remained equivalent between groups. Importantly, multivariable logistic regression did not identify BMI ≥ 30 kg/m 2 as an independent predictor of any complication (p = 0.21) or mortality (p = 0.74). Conclusions: Obesity does not influence operative characteristics or effect outcomes after OPCAB. BMI ≥ 30 kg/m 2 should not be considered a prohibitive risk factor in isolated off-pump coronary revascularization. (J Card Surg 2011;26:565-571)

Original languageEnglish (US)
Pages (from-to)565-571
Number of pages7
JournalJournal of Cardiac Surgery
Volume26
Issue number6
DOIs
StatePublished - Nov 1 2011

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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