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Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients

Authors
 Troy M Labounty  ;  Millie J Gomez  ;  Stephan Achenbach  ;  Mouaz Al-Mallah  ;  Daniel S Berman  ;  Matthew J Budoff  ;  Filippo Cademartiri  ;  Tracy Q Callister  ;  Hyuk-Jae Chang  ;  Victor Cheng  ;  Kavitha M Chinnaiyan  ;  Benjamin Chow  ;  Ricardo Cury  ;  Augustin Delago  ;  Allison Dunning  ;  Gudrun Feuchtner  ;  Martin Hadamitzky  ;  Jorg Hausleiter  ;  Philipp Kaufmann  ;  Yong-Jin Kim  ;  Jonathon Leipsic  ;  Fay Y Lin  ;  Erica Maffei  ;  Gilbert Raff  ;  Leslee J Shaw  ;  Todd C Villines  ;  James K Min 
Citation
 EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol.14(5) : 456-463, 2013-05 
Journal Title
 EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING 
ISSN
 2047-2404 
Issue Date
2013-05
MeSH
Age Distribution ; Aged ; Body Mass Index ; Confidence Intervals ; Coronary Angiography / methods ; Coronary Artery Disease / diagnostic imaging* ; Coronary Artery Disease / epidemiology* ; Disease Progression ; Female ; Humans ; Internationality ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction / diagnostic imaging* ; Myocardial Infarction / epidemiology ; Myocardial Infarction / physiopathology ; Obesity / diagnosis ; Obesity / epidemiology* ; Odds Ratio ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Assessment ; Severity of Illness Index ; Sex Distribution ; Survival Analysis ; Tomography, X-Ray Computed / methods
Abstract
Aims: Obesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA). Methods and results: We evaluated 13,874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m(2)), normal (20.1-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m(2), 95% confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m(2), 95% CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m(2), 95% CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m(2), 95% CI: 1.12-1.45, P < 0.001). Conclusions: Amongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction.
Files in This Item:
T201306423.pdf Download
DOI
10.1093/ehjci/jes179
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178463
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