Influence of overweight and obesity on the results of coronary artery bypass grafting on a working heart in patients of different age groups and the existence of an "obesity paradox"

Objective. To determine the effect of overweight and obesity on the results of coronary artery bypass grafting in patients of different age groups and the presence of the "obesity paradox". Materials and Methods. The study included 3674 patients (3061 men and 613 women) with coronary heart disease who underwent coronary artery bypass grafting on a beating heart. The average age of the study participants was (60.6 ± 0.8) years. Data from a clinical anthropometric study with the determination of body mass index and its interpretation were analyzed. The study design was based on the age group of patients in accordance with the age classification of the World Health Organization. Results. In the study sample, overweight patients accounted for 45.5%, and obese patients – 40.1%. The frequency of normal body weight increased with increasing age. In geriatric patients, this rate was statistically significantly higher than in young patients (p = 0.0001, χ2 = 31.13) and elderly patients (p = 0.05, χ2 = 3.84). The highest incidence of overweight was in elderly patients, and the lowest in young patients (p = 0.0001, χ2 = 22.95). The incidence of overweight also increased with increasing age. The incidence of obesity was highest in young patients and lowest in elderly patients (p = 0.0001, χ2 = 119.97). The incidence of obesity decreased with increasing age. Early postoperative mortality was statistically significantly higher in patients with normal body weight than in patients with overweight (p = 0.02, χ2 = 5.08). Conclusions. The sample of 3674 patients with coronary heart disease was dominated by overweight and obese patients of varying degrees, and only 14.4% of patients had normal and low body weight. Regarding the presence of the "obesity paradox" and the positive effect of overweight on the results of coronary artery bypass grafting on a beating heart, it was found that early postoperative mortality was statistically significantly (p = 0.02, χ2 = 5.08) higher in patients with normal body weight than in patients with exclusively overweight.