INFLUENCE OF OBESITY ON THE EARLY AND LONG-TERM RESULTS OF SURGERY FOR CORONARY-ARTERY DISEASE

被引：81

作者：

PRASAD, US

WALKER, WS

SANG, CTM

CAMPANELLA, C

CAMERON, EWJ

机构：

[1] Cardiac Surgery Unit, Royal Infirmary, Edinburgh

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1991年 / 5卷 / 02期

关键词：

OBESITY; CORONARY DISEASE; AORTOCORONARY BYPASS; CORONARY ARTERIOSCLEROSIS; ANGINA PECTORIS;

D O I：

10.1016/1010-7940(91)90003-3

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In order to determine the effect of obesity on the results of coronary artery bypass graft (CABG) surgery, we compared 250 obese patients undergoing CABG procedures between 1984 and 1987 with 250 age- and sex-matched controls of normal body mass index (BMI) undergoing CABG in the same period. The obese group had a greater incidence of diabetes mellitus (p < 0.02), hypertension (p < 0.05), hyperlipidaemia (p < 0.05), and left main stem coronary artery disease (p < 0.001). No differences were identified in the surgery performed, but obesity was associated with prolonged total bypass time (p < 0.05). Operative mortality was 0.8% in both groups. Multivariate analysis demonstrated obesity to be an independent risk factor for perioperative morbidity (p < 0.05). Univariate: respiratory (p < 0.01); leg wound (p < 0.001); myocardial infarction (p < 0.02); arrhythmias (p < 0.02); sternal dehiscence (p < 0.02). At a mean follow-up time of 36.9 months obese patients exhibited a greater incidence of significant recurrent angina (p < 0.01), which was associated with further weight gain (mean 12.2 kg; linear correlation: p < 0.001, r = 0.891). Although in CABG surgery operative mortality is not increased in obese patients, aggressive pre- and postoperative weight control is indicated to reduce both perioperative morbidity and the incidence of recurrent angina.

引用

页码：67 / 73

页数：7

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