Obesity and mortality after the first ischemic stroke: Is obesity paradox real?

Obesity is an established risk factor for ischemic stroke but the association of increased body mass index (BMI) with survival after ischemic stroke remains controversial. Many studies have shown that increased BMI has a "protective" effect on survival after stroke while other studies have...

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Vydané v:PloS one Ročník 16; číslo 2; s. e0246877
Hlavní autori: Chaudhary, Durgesh, Khan, Ayesha, Gupta, Mudit, Hu, Yirui, Li, Jiang, Abedi, Vida, Zand, Ramin
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Public Library of Science 10.02.2021
Public Library of Science (PLoS)
Predmet:
Aged
Aged, 80 and over
Asthma
Biocomplexity
Biology and Life Sciences
Body Mass Index
Cerebral infarction
Chronic obstructive pulmonary disease
Complications and side effects
Computer and Information Sciences
Congestive heart failure
Coronary artery disease
Diabetes mellitus
Diagnosis
Disease-Free Survival
Dyslipidemia
Editing
Electronic mail
Female
Fibrillation
Flutter
Genetics
Genomics
Health aspects
Heart failure
Hemorrhage
Humans
Hypertension
Ischemia
Ischemic Stroke - mortality
Ischemic Stroke - pathology
Kidney diseases
Liver diseases
Lung diseases
Male
Measurement
Medicine and Health Sciences
Methodology
Middle Aged
Mortality
Myocardial infarction
Neoplasms
Nervous system
Neurosciences
Normal distribution
Obesity
Obesity - mortality
Obesity - pathology
Obstructive lung disease
Occupational diseases
Overweight
Patient outcomes
Prevention
Retrospective Studies
Rheumatic diseases
Risk factors
Stroke
Stroke (Disease)
Survival Rate
Testing
Transient ischemic attack
Variance analysis
Vascular diseases
Weight reduction
United States
United States > US
Virginia
Pennsylvania
ISSN:1932-6203, 1932-6203
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Shrnutí:Obesity is an established risk factor for ischemic stroke but the association of increased body mass index (BMI) with survival after ischemic stroke remains controversial. Many studies have shown that increased BMI has a "protective" effect on survival after stroke while other studies have debunked the "obesity paradox". This study aimed at examining the relationship between BMI and all-cause mortality at one year in first-time ischemic stroke patients using a large dataset extracted from different resources including electronic health records. This was a retrospective cohort study of consecutive ischemic stroke patients captured in our Geisinger NeuroScience Ischemic Stroke (GNSIS) database. Survival in first-time ischemic stroke patients in different BMI categories was analyzed using Kaplan Meier survival curves. The predictors of mortality at one-year were assessed using a stratified Cox proportional hazards model. Among 6,703 first-time ischemic stroke patients, overweight and obese patients were found to have statistically decreased hazard ratio (HR) compared to the non-overweight patients (overweight patients- HR = 0.61 [95% CI, 0.52-0.72]; obese patients- HR = 0.56 [95% CI, 0.48-0.67]). Predictors with a significant increase in the hazard ratio for one-year mortality were age at the ischemic stroke event, history of neoplasm, atrial fibrillation/flutter, diabetes, myocardial infarction and heart failure. Our study results support the obesity paradox in ischemic stroke patients as shown by a significantly decreased hazard ratio for one-year mortality among overweight and obese patients in comparison to non-overweight patients.
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Competing Interests: The authors have read the journal’s policy and declare the following competing interests: RZ had financial research support from Bucknell University Initiative Program, Roche – Genentech Biotechnology Company. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0246877