Background:The effect of body weight (BW) on bleeding and ischemic events has not been adequately evaluated in real-world percutaneous coronary intervention (PCI) practice.

Methods and Results:12,690 consecutive patients undergoing first PCI in the CREDO-Kyoto registry cohort-2 were divided into 3 groups according to tertiles of BW stratified by sex (male; Tertile 1 [<60.0 kg], 2 [60.0–68.0 kg], and 3 [>68.0 kg], and female; Tertile 1 [<47.9 kg], 2 [47.9–55.8 kg], and 3 [>55.8 kg]). Cumulative 5-year incidences of the primary bleeding (GUSTO moderate/severe) and ischemic (myocardial infarction/ischemic stroke) endpoints increased incrementally with decrease in BW in both strata (male Tertiles 1, 2, and 3: 13.7%, 10.3%, and 8.0%, P<0.001, and 13.9%, 11.3%, and 10.2%, P<0.001; female Tertiles 1, 2, and 3: 17.9%, 12.9%, and 10.1%, P<0.001, and 17.9%, 12.9%, and 10.1%, P<0.001). Compared with Tertile 3, the adjusted risks of Tertile 1 for the primary bleeding and ischemic endpoints remained significant in the female stratum (hazard ratio (HR): 1.45, 95% confidence interval (CI): 1.14–1.87, P=0.003, and HR:1.49, 95% CI:1.13–1.95, P=0.004), but not in the male stratum (HR:1.10, 95% CI:0.92–1.32, P=0.31, and HR:1.06, 95% CI:0.90–1.27, P=0.47).

Conclusions:Cumulative incidences of bleeding and ischemic events increased incrementally as BW decreased in both men and women. The adjusted risks of underweight relative to overweight for bleeding and ischemic events were significant only in women.

背景：在实际的经皮冠状动脉介入治疗（PCI）实践中，尚未充分评估体重（BW）对出血和局部缺血事件的影响。

方法和结果：根据性别对BW的三分位数，将12690名在CREDO-Kyoto注册表研究组2中连续接受首次PCI的连续患者分为3组（男性；三分位数1 [<60.0 kg]，2 [60.0-68.0 kg]和3 [ > 68.0公斤]和雌性；三分位数1 [<47.9公斤]，2 [47.9-55.8公斤]和3 [> 55.8公斤]）。在两个阶层（男性三分位数1、2和3）中，随着BW的降低，原发性出血（GUSTO中度/重度）和缺血性（心肌梗塞/缺血性中风）终点的5年累积发生率逐渐增加。分别为8.0％（P <0.001和13.9％，11.3％和10.2％，P <0.001）；女性1、2和3：17.9％，12.9％和10.1％，P <0.001和17.9％， 12.9％和10.1％，P <0.001）。与Tertile 3相比，

结论：随着男女体重的降低，出血和缺血性事件的累积发生率逐渐增加。相对于超重而言，体重不足的失血和局部缺血事件的风险仅在女性中显着。