{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:39:50Z","timestamp":1779334790465,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005611","name":"University of Fukui","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005611","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Elevated body mass index (BMI) demonstrates lower all\u2010cause and cardiovascular mortalities compared with normal\u2010weight or lean patients in chronic diseases. This study investigated relationships between BMI and clinical outcomes following percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients, together with the sex\u2010specific impacts of BMI on mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed 1104 CAD patients who underwent PCI between 2006 and 2015. Patients were divided by BMI into three groups: lean, &lt;18.5\u00a0kg\/m<jats:sup>2<\/jats:sup>; normal, 18.5\u201324.9\u00a0kg\/m<jats:sup>2<\/jats:sup>; and overweight\/obese, \u226525\u00a0kg\/m<jats:sup>2<\/jats:sup>. The primary endpoint was all\u2010cause mortality, and the secondary endpoint was 3\u2010point major adverse cardiovascular events (MACE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Kaplan\u2013Meier survival analysis demonstrated risks of all\u2010cause death, and 3\u2010point MACE were higher in lean patients compared with normal\u2010weight and overweight\/obese subjects (log\u2010rank <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Cox proportional hazard modelling showed overweight\/obese was significantly associated with all\u2010cause death (hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.48\u20130.95; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03), and lean was significantly associated with 3\u2010point MACE (HR 2.02, 95% CI 1.15\u20133.53; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01). Cox proportional hazard analysis with restricted cubic spline showed non\u2010linear associations between BMI and both all\u2010cause mortality and 3\u2010point MACE (<jats:italic>p<\/jats:italic> for effect\u00a0=\u00a0.002 and =\u00a0.003, respectively). No significant interaction was evident between sex and BMI for all\u2010cause mortality (<jats:italic>p<\/jats:italic> for interaction\u00a0=\u00a0.104) or 3\u2010point MACE (<jats:italic>p<\/jats:italic> for interaction =0.122).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lean category was associated with adverse outcomes among CAD patients. An obesity paradox regarding the independent association of elevated BMI with reduced mortality after PCI is evident in both males and females.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13789","type":"journal-article","created":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T18:55:33Z","timestamp":1649530533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Relationship of body mass index to clinical outcomes after percutaneous coronary intervention"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7225-2819","authenticated-orcid":false,"given":"Tetsuji","family":"Morishita","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui  Fukui Japan"},{"name":"Department Cardiovascular Medicine National Hospital Organization Awara Hospital  Fukui Japan"},{"name":"Department of Internal Medicine Matsunami General Hospital  Gifu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyasu","family":"Uzui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Mitsuke","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui  Fukui Japan"},{"name":"Department Cardiovascular Medicine National Hospital Organization Awara Hospital  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1037"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60815-5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.3060"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.67.5.968"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.09.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-1-200301070-00008"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.06.009"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp288"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs217"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.03.018"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.03.013"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.1.55"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01802-2"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2013.02.009"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2009.10.004"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.01.006"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.11.011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.05.004"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-14-68"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-020-00669-z"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197112232852601"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31826e1058"},{"issue":"2","key":"e_1_2_8_24_1","first-page":"219","article-title":"The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease","volume":"1","author":"Sianos G","year":"2005","journal-title":"EuroIntervention"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-018-1191-8"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.12.034"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2009.02234.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.01.076"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07015-8"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12118"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12237"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.06.035"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJY14M12_11"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw334"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.4296"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.10.035"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.11.058"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.01.008"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2016.09.004"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-0015"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2012.11.034"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.13789","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T12:58:18Z","timestamp":1692881898000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.13789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,18]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1111\/eci.13789"],"URL":"https:\/\/doi.org\/10.1111\/eci.13789","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,18]]},"assertion":[{"value":"2022-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13789"}}