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Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients.
Eur Heart J Cardiovasc Imaging. 2013 May; 14(5):456-63.EH

Abstract

AIMS

Obesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA).

METHODS AND RESULTS

We evaluated 13,874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m(2)), normal (20.1-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m(2), 95% confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m(2), 95% CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m(2), 95% CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m(2), 95% CI: 1.12-1.45, P < 0.001).

CONCLUSIONS

Amongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction.

Authors+Show Affiliations

Department of Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, S. Mark Taper Bldg, Rm 1253, Los Angeles, CA 90048, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

22922955

Citation

Labounty, Troy M., et al. "Body Mass Index and the Prevalence, Severity, and Risk of Coronary Artery Disease: an International Multicentre Study of 13,874 Patients." European Heart Journal Cardiovascular Imaging, vol. 14, no. 5, 2013, pp. 456-63.
Labounty TM, Gomez MJ, Achenbach S, et al. Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients. Eur Heart J Cardiovasc Imaging. 2013;14(5):456-63.
Labounty, T. M., Gomez, M. J., Achenbach, S., Al-Mallah, M., Berman, D. S., Budoff, M. J., Cademartiri, F., Callister, T. Q., Chang, H. J., Cheng, V., Chinnaiyan, K. M., Chow, B., Cury, R., Delago, A., Dunning, A., Feuchtner, G., Hadamitzky, M., Hausleiter, J., Kaufmann, P., ... Min, J. K. (2013). Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients. European Heart Journal Cardiovascular Imaging, 14(5), 456-63. https://doi.org/10.1093/ehjci/jes179
Labounty TM, et al. Body Mass Index and the Prevalence, Severity, and Risk of Coronary Artery Disease: an International Multicentre Study of 13,874 Patients. Eur Heart J Cardiovasc Imaging. 2013;14(5):456-63. PubMed PMID: 22922955.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients. AU - Labounty,Troy M, AU - Gomez,Millie J, AU - Achenbach,Stephan, AU - Al-Mallah,Mouaz, AU - Berman,Daniel S, AU - Budoff,Matthew J, AU - Cademartiri,Filippo, AU - Callister,Tracy Q, AU - Chang,Hyuk-Jae, AU - Cheng,Victor, AU - Chinnaiyan,Kavitha M, AU - Chow,Benjamin, AU - Cury,Ricardo, AU - Delago,Augustin, AU - Dunning,Allison, AU - Feuchtner,Gudrun, AU - Hadamitzky,Martin, AU - Hausleiter,Jorg, AU - Kaufmann,Philipp, AU - Kim,Yong-Jin, AU - Leipsic,Jonathon, AU - Lin,Fay Y, AU - Maffei,Erica, AU - Raff,Gilbert, AU - Shaw,Leslee J, AU - Villines,Todd C, AU - Min,James K, Y1 - 2012/08/24/ PY - 2012/8/28/entrez PY - 2012/8/28/pubmed PY - 2013/11/15/medline SP - 456 EP - 63 JF - European heart journal cardiovascular Imaging JO - Eur Heart J Cardiovasc Imaging VL - 14 IS - 5 N2 - AIMS: Obesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA). METHODS AND RESULTS: We evaluated 13,874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m(2)), normal (20.1-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m(2), 95% confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m(2), 95% CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m(2), 95% CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m(2), 95% CI: 1.12-1.45, P < 0.001). CONCLUSIONS: Amongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction. SN - 2047-2412 UR - https://www.unboundmedicine.com/medline/citation/22922955/Body_mass_index_and_the_prevalence_severity_and_risk_of_coronary_artery_disease:_an_international_multicentre_study_of_13874_patients_ L2 - https://academic.oup.com/ehjcimaging/article-lookup/doi/10.1093/ehjci/jes179 DB - PRIME DP - Unbound Medicine ER -