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Relation of obesity to heart failure hospitalization and cardiovascular events in persons with stable coronary heart disease (from the Heart and Soul Study).
Am J Cardiol. 2009 Oct 01; 104(7):883-9.AJ

Abstract

Obesity is an independent risk factor for recurrent events among patients with established coronary heart disease (CHD). The goal of the present study was to identify potential mechanisms underlying this association. We measured the waist-to-hip ratio and body mass index in 979 outpatients with stable CHD and followed them for a mean of 4.9 years. We used proportional hazards models to evaluate the extent to which the association of obesity with subsequent heart failure (HF) hospitalization or cardiovascular (CV) events (myocardial infarction, stroke, or CHD death) was explained by baseline co-morbidities, cardiac disease severity, inflammation, insulin resistance, neurohormones and adipokines. Of the 979 participants, 128 (13%) were hospitalized for HF and 152 (16%) developed a CV event. Each standard deviation (SD) increase in the waist-to-hip ratio was associated with a 30% increased risk of HF hospitalization (unadjusted hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1 to 1.6). This association was not attenuated after adjustment for potential mediators (HR 1.6, 95% CI 1.2 to 2.1). Likewise, each SD increase in the waist-to-hip ratio was associated with a 20% greater risk of CV events (unadjusted HR 1.2, 95% CI 1.0 to 1.4), and this remained unchanged after adjustment for potential mediators (adjusted HR 1.3, 95% CI 1.0 to 1.5). The body mass index was not associated with the risk of HF or CV events. In conclusion, abdominal obesity is an independent predictor of HF hospitalization and recurrent CV events in patients with stable CHD. This association does not appear to be mediated by co-morbid conditions, cardiac disease severity, insulin resistance, inflammation, neurohormones, or adipokines.

Authors+Show Affiliations

Queen's Medical Center, Honolulu, HI, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

19766751

Citation

Spies, Christian, et al. "Relation of Obesity to Heart Failure Hospitalization and Cardiovascular Events in Persons With Stable Coronary Heart Disease (from the Heart and Soul Study)." The American Journal of Cardiology, vol. 104, no. 7, 2009, pp. 883-9.
Spies C, Farzaneh-Far R, Na B, et al. Relation of obesity to heart failure hospitalization and cardiovascular events in persons with stable coronary heart disease (from the Heart and Soul Study). Am J Cardiol. 2009;104(7):883-9.
Spies, C., Farzaneh-Far, R., Na, B., Kanaya, A., Schiller, N. B., & Whooley, M. A. (2009). Relation of obesity to heart failure hospitalization and cardiovascular events in persons with stable coronary heart disease (from the Heart and Soul Study). The American Journal of Cardiology, 104(7), 883-9. https://doi.org/10.1016/j.amjcard.2009.05.027
Spies C, et al. Relation of Obesity to Heart Failure Hospitalization and Cardiovascular Events in Persons With Stable Coronary Heart Disease (from the Heart and Soul Study). Am J Cardiol. 2009 Oct 1;104(7):883-9. PubMed PMID: 19766751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation of obesity to heart failure hospitalization and cardiovascular events in persons with stable coronary heart disease (from the Heart and Soul Study). AU - Spies,Christian, AU - Farzaneh-Far,Ramin, AU - Na,Beeya, AU - Kanaya,Alka, AU - Schiller,Nelson B, AU - Whooley,Mary A, PY - 2009/01/24/received PY - 2009/05/18/revised PY - 2009/05/18/accepted PY - 2009/9/22/entrez PY - 2009/9/22/pubmed PY - 2009/10/7/medline SP - 883 EP - 9 JF - The American journal of cardiology JO - Am J Cardiol VL - 104 IS - 7 N2 - Obesity is an independent risk factor for recurrent events among patients with established coronary heart disease (CHD). The goal of the present study was to identify potential mechanisms underlying this association. We measured the waist-to-hip ratio and body mass index in 979 outpatients with stable CHD and followed them for a mean of 4.9 years. We used proportional hazards models to evaluate the extent to which the association of obesity with subsequent heart failure (HF) hospitalization or cardiovascular (CV) events (myocardial infarction, stroke, or CHD death) was explained by baseline co-morbidities, cardiac disease severity, inflammation, insulin resistance, neurohormones and adipokines. Of the 979 participants, 128 (13%) were hospitalized for HF and 152 (16%) developed a CV event. Each standard deviation (SD) increase in the waist-to-hip ratio was associated with a 30% increased risk of HF hospitalization (unadjusted hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1 to 1.6). This association was not attenuated after adjustment for potential mediators (HR 1.6, 95% CI 1.2 to 2.1). Likewise, each SD increase in the waist-to-hip ratio was associated with a 20% greater risk of CV events (unadjusted HR 1.2, 95% CI 1.0 to 1.4), and this remained unchanged after adjustment for potential mediators (adjusted HR 1.3, 95% CI 1.0 to 1.5). The body mass index was not associated with the risk of HF or CV events. In conclusion, abdominal obesity is an independent predictor of HF hospitalization and recurrent CV events in patients with stable CHD. This association does not appear to be mediated by co-morbid conditions, cardiac disease severity, insulin resistance, inflammation, neurohormones, or adipokines. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/19766751/Relation_of_obesity_to_heart_failure_hospitalization_and_cardiovascular_events_in_persons_with_stable_coronary_heart_disease__from_the_Heart_and_Soul_Study__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)01094-7 DB - PRIME DP - Unbound Medicine ER -