Abstract 18591: Obesity With and Without Metabolic Syndrome - Association With Coronary Artery Disease and Adverse Cardiovascular Outcomes
Introduction: The relationship among body mass index (BMI), coronary artery disease (CAD), and cardiometabolic risk has not been thoroughly investigated among patients undergoing coronary computed tomography angiography (CCTA).
Methods: Retrospective cohort study of all CCTA scans at two hospitals within Partners Healthcare (Boston, Massachusetts) from Sep 2004 to Oct 2011. We included all patients who underwent CCTA who were > 18 years old with available BMI and metabolic syndrome (MetS) risk factors. CCTA were categorized as normal, non-obstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement score (SIS) and segment stenosis score (SSS). Extensive CAD was defined as SIS>4. We evaluated a primary outcome of major adverse cardiovascular events (cardiovascular mortality, non-fatal myocardial infarction, unstable angina, or coronary revascularization >90 days after CCTA).
Results: 1118 patients were included (57 ± 13 years old) with median follow-up 3.1 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p<0.001). Figure 1 demonstrates the odds of extensive CAD (SIS>4), according to MetS and BMI. Adverse events showed a J-shaped curve according to BMI (Figure 2, inset). The presence of MetS predicted worse outcomes within the BMI range of 20 [[Unable to Display Character: –]] 39.9(Figure 2). After adjustment for age and smoking, for BMI 20 [[Unable to Display Character: –]] 39.9 kg/m2, MetS (HR 2.23, p = 0.009) but not BMI was associated with prognosis.
Conclusions: Compared to normal BMI (20-24.9), there was an increased prevalence, extent, and severity of CAD for BMI > 25. BMI was not independently associated with adverse events but was a marker for MetS, which was associated with prognosis.
Author Disclosures: E. Hulten: None. M. Bittencourt: None. B. Ghoshhajra: None. R. Shah: None. S. Abbasi: None. S. Abbara: None. K. Nasir: None. M. Blaha: None. U. Hoffmann: None. M.F. Di Carli: None. R. Blankstein: None.
- © 2014 by American Heart Association, Inc.