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Eur Heart J. 2006 Jun;27(12):1416-22. Epub 2006 May 17.

Obesity and cardiovascular events in patients with established coronary disease.

Author information

  • 1The Clinical Trials Group, National Heart, Lung, and Blood Institute, Bethesda, MD, USA. domanskm@nhlbi.nih.gov

Abstract

AIMS:

To explore the association between obesity and major adverse coronary events (MACE) in patients with established coronary artery disease (CAD).

METHODS AND RESULTS:

The Prevention of Events with Angiotensin Converting Enzyme-Inhibition (PEACE) Trial randomized 8290 patients with stable CAD and left ventricular (LV) ejection fraction (EF) (LVEF) > or =0.40 to trandolapril or placebo and followed them for a median of 4.8 years. In PEACE patients who were non-diabetic at baseline (5693 men and 1171 women), we used proportional hazards models to conduct a post hoc analysis to examine whether obesity, defined as a body mass index (BMI) > or =30 kg/m(2), is an independent risk factor for the composite endpoint of MACE, defined as cardiovascular death, non-fatal myocardial infarction, coronary revascularization, or stroke. The analysis was conducted separately for men and women. The baseline prevalence of obesity was 28.5% in men and 28.9% in women. After adjusting for significant confounders, obesity was associated with MACE in men [hazard ratio (HR) = 1.28, 95% CI 1.13-1.46, P < 0.01], but not in women (HR = 0.96, 95% CI 0.70-1.31, P = 0.77). Further categorization of BMI showed a J-shaped association between BMI and MACE in the men, and no association in the women.

CONCLUSION:

In the presence of established CAD, obesity is associated with risk for MACE in men, but there is no support of an association in women. This finding requires further evaluation.

PMID:
16707546
DOI:
10.1093/eurheartj/ehl022
[PubMed - indexed for MEDLINE]
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