Impact of body mass index on acute outcome in percutaneous coronary intervention of chronic total occlusion.

Background: Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about the influence of body mass index (BMI) on acute outcome, including success rates and complications in CTO-PCI.

Methods: Between 2012 and 2017, we included 508 patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention. BMI was calculated according to the definitions of the World Health Organization. It was subdivided as normal weight (18.5-24.9 kg/m), overweight (25-29.9 kg/m), obese (30-34.9 kg/m), and very obese (≥35 kg/m). The Shapiro-Wilk test was used to test for normality of distribution. Continuous variables were tested for differences with Kruskal-Wallis or Mann-Whitney test as appropriate. Categorical variables were tested with Fisher exact test.

Results: Out of the 508 patients, 77 (15.2%) had normal weight, 286 (56.3%) were overweight, 106 (20.9%) obese, and 39 (7.7%) very obese. Radiation dose and examination time increased with elevated BMI categories ( < 0.001,  = 0.026). Success rates were similar in all BMI categories ( = 0.645). In-hospital procedural complications were rare and showed no statistically significant difference ( = 0.185).

Conclusions: Our retrospective study suggests that there exists no significant association between overweight and acute outcome in patients undergoing CTO-PCI. It is safe and feasible to perform.