TY - JOUR
T1 - Obesity, metabolic syndrome and cardiovascular prognosis
T2 - From the Partners coronary computed tomography angiography registry
AU - Hulten, Edward A.
AU - Bittencourt, Marcio Sommer
AU - Preston, Ryan
AU - Singh, Avinainder
AU - Romagnolli, Carla
AU - Ghoshhajra, Brian
AU - Shah, Ravi
AU - Abbasi, Siddique
AU - Abbara, Suhny
AU - Nasir, Khurram
AU - Blaha, Michael
AU - Hoffmann, Udo
AU - Di Carli, Marcelo F.
AU - Blankstein, Ron
N1 - Publisher Copyright:
© 2017 The Author(s).
PY - 2017/1/25
Y1 - 2017/1/25
N2 - Objective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.
AB - Objective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.
KW - Cohort
KW - Coronary artery disease
KW - Coronary computed tomography angiography
KW - Metabolic syndrome
KW - Obesity
KW - Prognosis
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U2 - 10.1186/s12933-017-0496-8
DO - 10.1186/s12933-017-0496-8
M3 - Article
C2 - 28122619
AN - SCOPUS:85011004593
SN - 1475-2840
VL - 16
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 14
ER -