OBJECTIVES: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based ona combination of body mass index (BMI) with measures of central obesity. BACKGROUND: In CAD patients, mortality has been reported to vary inversely with BMI (“obesity paradox”). In contrast,central obesity is directly associated with mortality. Because of this bidirectionality, we hypothesized that CAD patients with normal BMI but central obesity would have worse survival compared to individuals with other combinations of BMI and central adiposity. METHODS: We included 15,547 participants with CAD who were part of 5 studies from 3 continents. Multivariate stratifiedCox-proportional hazard models adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity. RESULTS: Mean age was 66 years, 60% were men. There were 5,507 deaths over a median follow-up of 2.4 years (IQR: 0.5 to 7.4 years). Individuals with normal weight central obesity had the worst long-term survival: a person with BMI of 22 kg/m2 and waist circumference (WC) of 101 cm had higher mortality than a person with similar BMI but WC of 85 cm (HR: 1.10[95% CI: 1.05 to 1.17]), than a person with BMI of 26 kg/m2 and WC of 85 cm (HR: 1.20 [95% CI: 1.09 to 1.31]), than a person with BMI of 30 kg/m2 and WC of 85 cm (HR: 1.61 [95% CI: 1.39 to 1.86]) and than a person with BMI of 30kg/m2 and WC of 101 cm (HR: 1.27 [95% CI: 1.18 to 1.39), p < 0.0001 for all). CONCLUSIONS: In patients with CAD, normal weight with central obesity is associated with the highest risk of mortality [corrected].
OBJECTIVES: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based ona combination of body mass index (BMI) with measures of central obesity. BACKGROUND: In CAD patients, mortality has been reported to vary inversely with BMI (“obesity paradox”). In contrast,central obesity is directly associated with mortality. Because of this bidirectionality, we hypothesized that CAD patients with normal BMI but central obesity would have worse survival compared to individuals with other combinations of BMI and central adiposity. METHODS: We included 15,547 participants with CAD who were part of 5 studies from 3 continents. Multivariate stratifiedCox-proportional hazard models adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity. RESULTS: Mean age was 66 years, 60% were men. There were 5,507 deaths over a median follow-up of 2.4 years (IQR: 0.5 to 7.4 years). Individuals with normal weight central obesity had the worst long-term survival: a person with BMI of 22 kg/m2 and waist circumference (WC) of 101 cm had higher mortality than a person with similar BMI but WC of 85 cm (HR: 1.10[95% CI: 1.05 to 1.17]), than a person with BMI of 26 kg/m2 and WC of 85 cm (HR: 1.20 [95% CI: 1.09 to 1.31]), than a person with BMI of 30 kg/m2 and WC of 85 cm (HR: 1.61 [95% CI: 1.39 to 1.86]) and than a person with BMI of 30kg/m2 and WC of 101 cm (HR: 1.27 [95% CI: 1.18 to 1.39), p < 0.0001 for all). CONCLUSIONS: In patients with CAD, normal weight with central obesity is associated with the highest risk of mortality [corrected].
Authors: Rodrigo Octavio Deliberato; Ary Serpa Neto; Matthieu Komorowski; David J Stone; Stephanie Q Ko; Lucas Bulgarelli; Carolina Rodrigues Ponzoni; Renato Carneiro de Freitas Chaves; Leo Anthony Celi; Alistair E W Johnson Journal: Crit Care Med Date: 2019-02 Impact factor: 7.598
Authors: Yong-Moon Mark Park; Alexandra J White; Hazel B Nichols; Katie M O'Brien; Clarice R Weinberg; Dale P Sandler Journal: Int J Cancer Date: 2017-03-28 Impact factor: 7.396
Authors: R Padwal; F A McAlister; J J V McMurray; M R Cowie; M Rich; S Pocock; K Swedberg; A Maggioni; G Gamble; C Ariti; N Earle; G Whalley; K K Poppe; R N Doughty; A Bayes-Genis Journal: Int J Obes (Lond) Date: 2013-10-31 Impact factor: 5.095
Authors: John A Batsis; Alicia J Zbehlik; Emily A Scherer; Laura K Barre; Stephen J Bartels Journal: J Am Geriatr Soc Date: 2015-07-14 Impact factor: 5.562
Authors: Nathalie Jean; Virend K Somers; Ondrej Sochor; Jose Medina-Inojosa; Ernesto M Llano; Francisco Lopez-Jimenez Journal: Curr Atheroscler Rep Date: 2014-12 Impact factor: 5.113
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