Abstract 11314: Inverse Relationship Between Body Mass Index and Coronary Artery Calcification in Older Patients with Clinically Significant Coronary Lesions
Background: Extensive animal and clinical data indicate a ‘calcification paradox’, whereby reduced bone mineral density is associated with increased vascular calcification. In addition, it is well described that reduced bone mineral density is prevalent in leaner persons with small body size. Therefore, although a positive relationship exists between body mass index (BMI) and coronary artery calcification (CAC) in younger persons, we hypothesized that in older persons and/or those at risk for osteoporosis an inverse relationship between BMI and CAC may apply.
Methods: We accessed our single-center registry for 07/1999 - 06/2009, identifying 20068 consecutive patients (age 65.9 ± 12.1; 34.3% females) that underwent percutaneous coronary intervention (PCI). Index lesion calcification (ILC; none, mild, moderate, severe) was analyzed with respect to BMI.
Results: Lower BMI was observed among those with greater ILC. Comparing index lesions with no angiographic calcification to those with the most severe, mean BMI decreased by 1.29 kg.m-2; a reduction of 4.5% (P < 0.0005). BMI was a univariable inverse predictor of moderate-severe ILC (m-sILC; Odds Ratio [OR] 0.967; 95%CI 0.959 - 0.975; P< 0.0001). In fully adjusted logistic regression models this relationship persisted despite controlling for multiple cardiovascular risk factors and other predictors of CAC (OR for BMI predicting m-sILC = 0.976; 95%CI 0.968 - 0.985; P< 0.0001) (Table). Further fully adjusted models for predictors of m-sILC identified that, compared to having a normal BMI, overweight patients had an OR of 0.888 (95% CI 0.793 - 0.995, P = 0.04), while obese patients had an OR of 0.75 (95% CI 0.659 - 0.854, P < 0.0001).
Conclusion; In a large cohort of PCI patients we identified an independent inverse relationship between BMI and index lesion calcification. This association is consistent with established paradigms and suggests a complex interrelationship between BMI, body size and vascular calcification.
- © 2011 by American Heart Association, Inc.