Abstract 4106: Effect of Obesity on Progression of Coronary Atherosclerosis: Observations from Four Intravascular Ultrasound Trials
Introduction: The impact of obesity on progression of coronary atherosclerosis is largely unknown. We investigated this relationship by using serial intravascular ultrasound (IVUS).
Methods: 1515 patients completing the four major IVUS trials reported to date (REVERSAL, CAMELOT, ACTIVATE, and ASTEROID) were included in a pooled analysis. All patients had angiographically documented coronary artery disease. The relationship between body-mass index (BMI) and progression rate of coronary atherosclerosis as determined by IVUS (annualized change in atheroma volume) was evaluated. Additionally, the progression rates of obese (i.e. BMI≥30) and non-obese patients (i.e. BMI<30) were compared.
Results: The baseline BMI of the study population averaged 30.2±5.5. Overall, 662 (44%) of the patients were obese and 853 (56%) were not. During the trials, almost all patients underwent statin therapy (95% in both obese and non-obese). There was a significant correlation between BMI and change in atheroma volume both on univariable (r=0.08, p=0.002) and multivariable analysis controlling for on-treatment low-density lipoprotein cholesterol (r=0.07, p=0.006). Similarly, when analyzed as a dichotomous variable, obesity was associated with a significantly faster progression of coronary atherosclerosis (Figure⇓).
Conclusion: This analysis for the first time shows that in patients with established coronary artery disease undergoing statin therapy, obesity is associated with faster progression of coronary atherosclerosis. These results highlight the need to emphasize control of obesity to slow progression of coronary atherosclerosis.