Abstract 15413: Increased Body Mass Index is Associated with Greater Prevalence, Extent, and Severity of Coronary Artery Disease and Increased Adverse Events
Introduction: Higher body mass index (BMI) is associated with increased cardiac risk factors, but its relationship with incident coronary artery disease (CAD) and adverse events is not clear.
Methods: We examined 14,751 patients without known CAD in a multinational registry of individuals undergoing coronary computed tomographic angiography (CCTA), and compared risk factors, patterns of CAD, and adverse events (death or myocardial infarction) stratified by normal (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2) BMI.
Results: Mean age was 56.4±11.8 years, 55.8% were male, and mean follow-up was 2.5±1.2 years with 338 adverse events (85 deaths and 253 myocardial infarctions). Prevalence of diabetes (10% in normal BMI vs. 12% in overweight vs. 21% in obese), hypertension (37% vs. 46% vs. 59%), and hyperlipidemia (48% vs. 54% vs. 55%) significantly increased with higher BMI (p<0.001 for all). After adjustment for risk factors, increased BMI was associated with greater prevalence, extent, and severity of CAD as measured by the Duke score [+0.12 score per +5 kg/m2, 95% confidence interval (CI) 0.10-0.15], segment stenosis score (+0.31 score per +5 kg/m2, 95% CI 0.24-0.37), presence of any CAD [odds ratio (OR) 1.25, 95% CI 1.20-1.30], and presence of obstructive (≥50% stenosis) CAD (OR 1.13, 95% CI 1.08-1.18)(p<0.001 for all). In comparison to those with a normal BMI, overweight and obese individuals had increased adverse events (Figure 1). After adjusting for risk factors, a higher BMI was independently associated with greater adverse events (OR 1.34 per +5 kg/m2, 95% CI 1.29-1.50, p<0.001).
Conclusions: Overweight and obese patients have increased prevalence of CAD risk factors; and greater prevalence, extent, and severity of CAD that does not appear to be explained by risk factors alone. Further, higher BMI is associated with increased adverse events.Figure 1. Kaplan-Meier Curve for Non-Fatal Myocardial Infarction and All-Cause Mortality
- © 2011 by American Heart Association, Inc.