Literature DB >> 18516395

Obesity and coronary intervention: should we continue to use Body Mass Index as a risk factor?

José Carlos Estival Tarastchuk1, Enio Eduardo Guérios, Ronaldo da Rocha Loures Bueno, Paulo Maurício Piá de Andrade, Deborah Christina Nercolini, João Gustavo Gongora Ferraz, Eduardo Doubrawa.   

Abstract

BACKGROUND: Central anthropometric indexes are better than the body mass index to discriminate elevated coronary risk. However, the Body Mass Index (BMI) is still the most frequently studied anthropometric index on outcomes of patients undergoing percutaneous coronary angioplasty (PCI).
OBJECTIVE: To recognize, among several anthropometric indexes of obesity, which one best discriminates MACE (Major Adverse Cardiac Events) after PCI.
METHODS: Subjects were 308 patients (mean age 61.92+/-11.06 years, 60.7% of them men) who had undergone successful coronary angioplasties. Six months after the procedure, patients were contacted for clinical follow-up. Major Adverse Cardiac Events included death, acute myocardial infarction, cardiac surgery, reintervention, angina, or evidence of myocardial ischemia on a non-invasive test. Patients were divided into 2 groups: Group 1 (with MACE, n=91, 29.5%), Group 2 (with no MACE, n= 217; 70.45%). For men and women, the anthropometric indexes studied and their respective cut-off points were waist circumference >90/80 cm, Waist-Hip Ratio > 0.90/0.80 cm, Conicity Index > 1.25/1.18, and Body Mass Index > or =30.
RESULTS: There were more cases of familial history and previous infarct in Group 2. For men, waist circumference >90 cm (p=0.0498) in multivariate analyses was an independent predictor of MACE. BMI was not related to MACE. In Group 1, the prevalence of an elevated BMI was significantly different compared to the other anthropometric indexes studied (p<0.0001).
CONCLUSION: Waist circumference was an independent predictor of MACE in men. Body Mass Index was not related to MACE and was the least frequent anthropometric index in the MACE group.

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Year:  2008        PMID: 18516395     DOI: 10.1590/s0066-782x2008000500001

Source DB:  PubMed          Journal:  Arq Bras Cardiol        ISSN: 0066-782X            Impact factor:   2.000


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