BACKGROUND: Weight loss is recommended among overweight survivors of myocardial infarction (MI). This study describes patterns of weight change among overweight patients with MI and identifies factors associated with weight change. METHODS: A prospective cohort of 1253 overweight or heavier (body mass index [BMI] > or = 25 kg/m2) post-MI patients were enrolled in the 19-center PREMIER study and followed up for 1 year to determine changes in weight. Patients were categorized at 1 month as overweight (BMI = 25-29.9 kg/m2), obese (BMI = 30-39.9 kg/m2), or morbidly obese (BMI > or = 40 kg/m2). Unadjusted percent weight change was assessed at 1 year, and multivariable linear regression was used to identify independent correlates of change. RESULTS: Mean weight change was -0.2% and varied by the severity of baseline obesity (+0.4% for overweight patients, -0.5% for obese patients, and -3.7% for morbidly obese patients [P < .001]). Multivariable analyses revealed the following to be significantly associated with weight change: depression 1 month post-MI (+2.7%, P = .001), lack of health insurance (+2%, P = .01), smoking cessation 1 month post-MI (+2.7% vs current smokers, P < .001), morbid obesity (+4.7% vs overweight patients, P < .0001), and increasing age (-0.8% per decade, P = .001). An interaction between smoking cessation and weight class was detected in that overweight patients who quit had a mean increase of 5.3% (95% CI 3.1%-7.4%), whereas no significant change was observed among obese and morbidly obese patients who quit. CONCLUSIONS: Although post-MI patients had negligible weight loss over 1 year, several sociodemographic, clinical, and lifestyle characteristics were associated with weight change. New, targeted interventions will likely be needed to improve weight management after an MI.
BACKGROUND:Weight loss is recommended among overweight survivors of myocardial infarction (MI). This study describes patterns of weight change among overweight patients with MI and identifies factors associated with weight change. METHODS: A prospective cohort of 1253 overweight or heavier (body mass index [BMI] > or = 25 kg/m2) post-MI patients were enrolled in the 19-center PREMIER study and followed up for 1 year to determine changes in weight. Patients were categorized at 1 month as overweight (BMI = 25-29.9 kg/m2), obese (BMI = 30-39.9 kg/m2), or morbidly obese (BMI > or = 40 kg/m2). Unadjusted percent weight change was assessed at 1 year, and multivariable linear regression was used to identify independent correlates of change. RESULTS: Mean weight change was -0.2% and varied by the severity of baseline obesity (+0.4% for overweight patients, -0.5% for obesepatients, and -3.7% for morbidly obesepatients [P < .001]). Multivariable analyses revealed the following to be significantly associated with weight change: depression 1 month post-MI (+2.7%, P = .001), lack of health insurance (+2%, P = .01), smoking cessation 1 month post-MI (+2.7% vs current smokers, P < .001), morbid obesity (+4.7% vs overweight patients, P < .0001), and increasing age (-0.8% per decade, P = .001). An interaction between smoking cessation and weight class was detected in that overweight patients who quit had a mean increase of 5.3% (95% CI 3.1%-7.4%), whereas no significant change was observed among obese and morbidly obesepatients who quit. CONCLUSIONS: Although post-MI patients had negligible weight loss over 1 year, several sociodemographic, clinical, and lifestyle characteristics were associated with weight change. New, targeted interventions will likely be needed to improve weight management after an MI.
Authors: Joshua F Baker; Grant W Cannon; Said Ibrahim; Candace Haroldsen; Liron Caplan; Ted R Mikuls Journal: J Rheumatol Date: 2015-04-01 Impact factor: 4.666
Authors: Siddharth Singh; Virend K Somers; Matthew M Clark; Kristin Vickers; Donald D Hensrud; Yoel Korenfeld; Francisco Lopez-Jimenez Journal: Am Heart J Date: 2010-11 Impact factor: 4.749
Authors: Jeff C Huffman; Felicia A Smith; Gregory L Fricchione; James L Januzzi; Sara Nadelman; William F Pirl Journal: Prim Care Companion J Clin Psychiatry Date: 2010
Authors: Joyce W Tang; Norrina Allen; Peter de Chavez; David C Goff; Catarina I Kiefe; Cora E Lewis; Mercedes Carnethon Journal: Public Health Nutr Date: 2012-08-16 Impact factor: 4.022
Authors: Emily M Bucholz; Saif S Rathore; Kimberly J Reid; Philip G Jones; Paul S Chan; Michael W Rich; John A Spertus; Harlan M Krumholz Journal: Am J Med Date: 2012-04-05 Impact factor: 4.965
Authors: Benjamin J Keeney; Deborah Fulton-Kehoe; Thomas M Wickizer; Judith A Turner; Kwun Chuen Gary Chan; Gary M Franklin Journal: J Occup Environ Med Date: 2013-03 Impact factor: 2.162