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Cardiovasc Diabetol. 2017 Jan 25;16(1):14. doi: 10.1186/s12933-017-0496-8.

Obesity, metabolic syndrome and cardiovascular prognosis: from the Partners coronary computed tomography angiography registry.

Author information

1
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2
Cardiology Service, Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA.
3
Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil.
4
Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA.
5
Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
6
Cardiology Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
7
Cardiothoracic Imaging Division, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9316, USA.
8
Center for Wellness and Prevention Research, Baptist Health South Florida, Miami, FL, USA.
9
Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
10
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rblankstein@partners.org.
11
Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. rblankstein@partners.org.

Abstract

OBJECTIVE:

To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA).

METHODS:

Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models.

RESULTS:

Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events.

CONCLUSIONS:

Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.

KEYWORDS:

Cohort; Coronary artery disease; Coronary computed tomography angiography; Metabolic syndrome; Obesity; Prognosis

PMID:
28122619
PMCID:
PMC5264456
DOI:
10.1186/s12933-017-0496-8
[Indexed for MEDLINE]
Free PMC Article

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