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Aug 13, 2013

More Obese Patients Needing Angioplasty than Ever Before

Younger, morbidly obese patients undergoing percutaneous coronary intervention are also at greater risk for complications, study finds.

There’s no question that obesity greatly increases risk for developing heart disease. And with more Americans obese than ever before, it’s not surprising that the number of obese patients requiring angioplasty has nearly doubled since the ‘90s, according to a recent study.

Published in the Journal of the American College of Cardiology, this study looked at the proportion of morbidly obese patients undergoing percutaneous coronary intervention (also referred to as angioplasty)—a non-surgical procedure used to restore normal blood flow in patients with clogged arteries. Using a detailed registry, researchers identified more than 227,000 patients who underwent this procedure between 1998 and 2009 in the state of Michigan. Patients were divided into four categories based on their body mass index—lean, overweight, obese, and morbidly obese—and researchers compared outcomes based on weight.

After analysis, researchers found that the proportion of morbidly obese patients undergoing angioplasty nearly doubled between 1998 and 2009, increasing from 4.38% to 8.36% during this 11-year period. Compared to patients who were considered overweight, morbidly obese patients had significantly greater risk of complications and death from the procedure. And perhaps most concerning, morbidly obese patients were more likely to have diabetes and were much younger than the other groups (59.2 years old vs. 64.9 years old in the overweight group).

With an estimated one in 20 Americans morbidly obese, these findings are alarming. Despite morbidly obese patients being more than five years younger on average, they actually fared worse than older, overweight patients undergoing percutaneous coronary intervention. It’s possible that small changes to the procedure like the access site could make this procedure safer for morbidly obese patients, but the best way to improve outcomes is by helping patients achieve healthier weights. Morbid obesity (body mass index greater than 40) is a serious health condition that greatly increases risk for heart disease and other serious health issues, and can even interfere with basic physical functions, such as breathing or walking. Since morbidly obese patients have even greater risk for complications from heart procedures like angioplasty, reducing weight is the best way to prevent ever needing such procedures that can put a patient’s health at further risk.

Questions for You to Consider

  • What is a healthy weight for me?
  • A few important tools can be used to determine if an individual is underweight, normal weight or overweight. The easiest tool is a Body Mass Index, which is calculated using height and weight to estimate levels of body fat. However, Body Mass Index is not always accurate, particularly among individuals with extremely high or low amounts of muscle. In these cases, measuring waist circumference is helpful in assessing weight, as a waist circumference greater than 35 inches for a woman or 40 inches for a man is considered unhealthy.
  • What is percutaneous coronary intervention (PCI)?

  • Percutaneous coronary intervention (often referred to as balloon angioplasty or simply angioplasty) is often recommended for patients diagnosed with diseased arteries of the heart (coronary arteries) or for patients suffering a heart attack. Percutaneous coronary intervention includes a variety of procedures developed to compress fat and cholesterol build-up in the arteries, known as plaque deposits, to help increase the size of narrowed or blocked arteries and improve blood and oxygen flow to the heart.


Phillip Cartozian is CardioSmart

More than 20 years ago, Phillip Cartozian had two heart attacks and quintuple bypass surgery. Afterward, he changed his diet completely and ate fruit, vegetables and fish every day.

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