Impact of body mass index on outcomes in patients undergoing transfemoral transcatheter aortic valve implantation

abstract Objective This CENTER study sought to investigate the effect of body mass (BMI) on outcomes in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). Methods 12,381 patients undergoing transfemoral TAVI were divided into BMI categories: underweight ( 30 kg/m2). Primary endpoints were differences in 30-day and one-year all-cause mortality. Secondary endpoints included all other clinical endpoints such as stroke. Univariate and multivariate odds ratios (OR) were calculated using logistic and cox regression analyses. Results Two percent (n=205) of the patients were underweight, 29% (n=3564) normal weight, 44% (n=5460) overweight and 25% (n=3152) were obese. Thirty-day mortality was lower in overweight (5.3%, OR=0.73 (95%CI 0.61-0.88, p=0.001)) and obese patients (5.2%, OR=0.74 (95%CI 0.60-0.92, p=0.006)), but higher in underweight (9.8%(OR=1.51 (95%CI 0.92-2.47, p=0.010)) as compared to normal weight patients (6.9%). After multivariate adjustment, 30-day mortality was not significantly different across BMI categories. However, one-year mortality was higher in underweight patients (HR=1.52(95%CI 1.10-2.09, p=0.011)). Stroke rates were comparable between BMI groups. Conclusions For overweight and obese patients with severe aortic valve stenosis undergoing TAVI, there was no 30-day difference in mortality compared to normal weight. However, underweight patients showed higher rates of one-year mortality after TAVI.