BACKGROUND: The relationship of changes in weight to outcomes in patients after myocardial infarction (MI) is controversial. METHODS: From the ENRICHD trial data, we assessed weight change, and the associations of baseline weight and change at follow-up with outcomes and interactions between psychosocial factors. RESULTS: At baseline, 73.6% of patients (n = 1706) were overweight or obese; 134 patients had body mass index of > or = 40. Underweight patients were more likely to die or have nonfatal recurrent MI. After controlling for covariates, overweight and obese patients had similar outcomes to normal-weight patients. Eighteen percent of patients gained > 5%, 27% lost > 5%, and 55% had < or = 5% change in weight. Compared with weight loss of < or = 5%, the risk of death (adjusted hazard ratio 1.74, P = .01) and cardiovascular death (hazard ratio 1.79, P = .04) increased with weight loss of > 5%. After propensity matching, weight loss of > 5% remained as a significant risk factor for death and cardiovascular death. There was no interaction between weight change and depression and/or social support at baseline or follow-up. Weight change was not associated with recurrent MI or cardiovascular hospitalizations. CONCLUSIONS: A large proportion of patients lose or gain > 5% of body weight after an MI. The association between obesity and lower mortality is modulated by comorbidities. Weight loss after MI is associated with worse outcomes and is not related to depression or social support.
RCT Entities:
BACKGROUND: The relationship of changes in weight to outcomes in patients after myocardial infarction (MI) is controversial. METHODS: From the ENRICHD trial data, we assessed weight change, and the associations of baseline weight and change at follow-up with outcomes and interactions between psychosocial factors. RESULTS: At baseline, 73.6% of patients (n = 1706) were overweight or obese; 134 patients had body mass index of > or = 40. Underweight patients were more likely to die or have nonfatal recurrent MI. After controlling for covariates, overweight and obesepatients had similar outcomes to normal-weight patients. Eighteen percent of patients gained > 5%, 27% lost > 5%, and 55% had < or = 5% change in weight. Compared with weight loss of < or = 5%, the risk of death (adjusted hazard ratio 1.74, P = .01) and cardiovascular death (hazard ratio 1.79, P = .04) increased with weight loss of > 5%. After propensity matching, weight loss of > 5% remained as a significant risk factor for death and cardiovascular death. There was no interaction between weight change and depression and/or social support at baseline or follow-up. Weight change was not associated with recurrent MI or cardiovascular hospitalizations. CONCLUSIONS: A large proportion of patients lose or gain > 5% of body weight after an MI. The association between obesity and lower mortality is modulated by comorbidities. Weight loss after MI is associated with worse outcomes and is not related to depression or social support.
Authors: Brian D Powell; Ryan J Lennon; Amir Lerman; Malcolm R Bell; Peter B Berger; Stuart T Higano; David R Holmes; Charanjit S Rihal Journal: Am J Cardiol Date: 2003-02-15 Impact factor: 2.778
Authors: Francisco Lopez-Jimenez; Steven J Jacobsen; Guy S Reeder; Susan A Weston; Ryan A Meverden; Véronique L Roger Journal: Chest Date: 2004-04 Impact factor: 9.410
Authors: Edward M Castillo; Deborah Goodman-Gruen; Donna Kritz-Silverstein; Deborah J Morton; Deborah L Wingard; Elizabeth Barrett-Connor Journal: Am J Prev Med Date: 2003-10 Impact factor: 5.043
Authors: Joseph Kim; Niklas Hammar; Kristina Jakobsson; Russell V Luepker; Paul G McGovern; Torbjörn Ivert Journal: Am Heart J Date: 2003-09 Impact factor: 4.749
Authors: Lisa F Berkman; James Blumenthal; Matthew Burg; Robert M Carney; Diane Catellier; Marie J Cowan; Susan M Czajkowski; Robert DeBusk; James Hosking; Allan Jaffe; Peter G Kaufmann; Pamela Mitchell; James Norman; Lynda H Powell; James M Raczynski; Neil Schneiderman Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
Authors: Paulina Cruz; Bruce D Johnson; Susan C Karpinski; Katherine A Limoges; Beth A Warren; Kerry D Olsen; Virend K Somers; Michael D Jensen; Matthew M Clark; Francisco Lopez-Jimenez Journal: Obesity (Silver Spring) Date: 2011-05-12 Impact factor: 5.002
Authors: L Reider; W Hawkes; J R Hebel; C D'Adamo; J Magaziner; R Miller; D Orwig; D E Alley Journal: J Nutr Health Aging Date: 2013-01 Impact factor: 4.075
Authors: Lorenzo De Paola; Arnav Mehta; Tiberiu A Pana; Ben Carter; Roy L Soiza; Mohannad W Kafri; John F Potter; Mamas A Mamas; Phyo K Myint Journal: J Clin Med Date: 2022-05-05 Impact factor: 4.964
Authors: Carlos M Diaz-Melean; Virend K Somers; Juan Pablo Rodriguez-Escudero; Prachi Singh; Ondrej Sochor; Ernesto Manuel Llano; Francisco Lopez-Jimenez Journal: Curr Atheroscler Rep Date: 2013-11 Impact factor: 5.113
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: Laila Al-Shaar; Yanping Li; Eric B Rimm; JoAnn E Manson; Bernard Rosner; Frank B Hu; Meir J Stampfer; Walter C Willett Journal: Am J Epidemiol Date: 2021-10-01 Impact factor: 4.897
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