AIMS: To examine the prognostic importance of weight-change in patients with coronary artery disease (CAD), especially following acute myocardial infarction (AMI). METHODS AND RESULTS: In 4360 AMI patients (OPTIMAAL trial) without baseline oedema, we assessed 3-month weight-change, baseline body mass index (BMI), demographics, patient history, medication, physical examination, and biochemical analyses. Weight-change was defined as change >+/-0.1 kg/baseline BMI-unit. Patients were accordingly categorized into three groups; weight-loss, weight-stability, and weight-gain. Our findings were validated in 4012 AMI patients (CONSENSUS II trial) and 4178 stable CAD patients (79% with prior AMI, 4S trial). Median follow-up was 2.7 years, 3 months, and 4.4 years, respectively. In OPTIMAAL, 3-month weight-loss (vs. weight-stability) independently predicted increased all-cause death [n=471; hazard ratio (HR) 1.26; 95% CI 1.01-1.56; P=0.039] and cardiac death (n=299, HR 1.33, 95% CI 1.02-1.73, P=0.034). Weight-gain yielded risk similar to weight-stability (HR 1.07, P=0.592 and 0.97, P=0.866, respectively). In CONSENSUS II, 3-month weight-loss independently predicted increased mortality (HR 3.87, P=0.008). Weight-gain yielded risk similar to weight-stability (HR 1.11, P=0.860). In 4S, 1-year weight-loss independently predicted increased mortality (HR 1.44, P=0.004). Weight-gain conferred risk similar to weight-stability (HR 1.05, P=0.735). CONCLUSION: In patients following AMI or with stable CAD, weight-loss but not weight-gain was independently associated with increased mortality risk.
AIMS: To examine the prognostic importance of weight-change in patients with coronary artery disease (CAD), especially following acute myocardial infarction (AMI). METHODS AND RESULTS: In 4360 AMI patients (OPTIMAAL trial) without baseline oedema, we assessed 3-month weight-change, baseline body mass index (BMI), demographics, patient history, medication, physical examination, and biochemical analyses. Weight-change was defined as change >+/-0.1 kg/baseline BMI-unit. Patients were accordingly categorized into three groups; weight-loss, weight-stability, and weight-gain. Our findings were validated in 4012 AMI patients (CONSENSUS II trial) and 4178 stable CAD patients (79% with prior AMI, 4S trial). Median follow-up was 2.7 years, 3 months, and 4.4 years, respectively. In OPTIMAAL, 3-month weight-loss (vs. weight-stability) independently predicted increased all-cause death [n=471; hazard ratio (HR) 1.26; 95% CI 1.01-1.56; P=0.039] and cardiac death (n=299, HR 1.33, 95% CI 1.02-1.73, P=0.034). Weight-gain yielded risk similar to weight-stability (HR 1.07, P=0.592 and 0.97, P=0.866, respectively). In CONSENSUS II, 3-month weight-loss independently predicted increased mortality (HR 3.87, P=0.008). Weight-gain yielded risk similar to weight-stability (HR 1.11, P=0.860). In 4S, 1-year weight-loss independently predicted increased mortality (HR 1.44, P=0.004). Weight-gain conferred risk similar to weight-stability (HR 1.05, P=0.735). CONCLUSION: In patients following AMI or with stable CAD, weight-loss but not weight-gain was independently associated with increased mortality risk.
Authors: Susan Stienen; João Pedro Ferreira; Nicolas Girerd; Kévin Duarte; Zohra Lamiral; John J V McMurray; Bertram Pitt; Kenneth Dickstein; Faiez Zannad; Patrick Rossignol Journal: Clin Res Cardiol Date: 2019-04-05 Impact factor: 5.460
Authors: Suzanne V Arnold; John A Spertus; Kasia J Lipska; David E Lanfear; Fengming Tang; Anna Grodzinsky; Darren K McGuire; M Odette Gore; Abhinav Goyal; Thomas M Maddox; Mikhail Kosiborod Journal: Am Heart J Date: 2014-06-09 Impact factor: 4.749
Authors: Quinn R Pack; Juan Pablo Rodriguez-Escudero; Randal J Thomas; Philip A Ades; Colin P West; Virend K Somers; Francisco Lopez-Jimenez Journal: Mayo Clin Proc Date: 2014-09-08 Impact factor: 7.616
Authors: Won Yu Kang; Seung Hwan Hwang; Sun Ho Hwang; Wan Kim; Keun Ho Park; Young Joon Hong; Ju Han Kim; Youngkeun Ahn; Myung Ho Jeong Journal: Chonnam Med J Date: 2012-04-26