Abstract:

Objective: It is claimed in obesity paradox that high weight patients are protected from risks developed after coronary artery bypass grafting. However, the severity of coronary artery disease has not been clarified by using objective methods in the reports of obesity paradox. We believe that they have reached such a paradoxical finding as a result of operations in obese patients with relatively less risky coronary artery disease. Our purpose is to clarify whether angiographic severity (using Gensini score) affects early outcomes after coronary artery bypass grafting in high weight patients undergoing coronary artery bypass surgery. Material and Method: Clinical and angiographic data from a total of 126 patients with a body mass index of ≥ 30 kg/m2 undergoing isolated coronary artery bypass grafting were included. Primary outcome of interest was postoperative occurrence of early low cardiac output syndrome. Angiographic score of each patient was calculated according to the method described by Gensini. Factors associated with primary outcome were evaluated using multivariate analysis. Results: Low cardiac output syndrome occurred in 27 patients (21.4%). In multivariate analysis cross clamp time (OR: 1.064, 95% CI 1.026-1.103, p:0.001), age (OR: 1.099, 95% CI 1.028-1.175, p:0.006) and Gensini score (OR: 1.025, 95% CI 1.006-1.044, p:0.008) were found to be independent predictors of low cardiac output syndrome after coronary artery bypass grafting. Conclusion: Overweight patients with higher Gensini angiographic scores more tend to have low cardiac output syndrome after CABG than those with lower scores. Protective effects of obesity against postoperative risks after coronary artery bypass grafting should be revisited.

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