Relation of Waist-Hip Ratio to Long-term Cardiovascular Events in Patients with Coronary Artery Disease

Details

• Alternative Title:
  Am J Cardiol
• Personal Author:
  Medina-lnojosa, Jose R. ; Batsis, John A. ; Supervia, Marta ; Somers, Virend K. ; Thomas, Randal ; Jenkins, Sarah ; Grimes, Chassidy ; Lopez-Jimenez, Francisco
• Description:
  We aimed to assess the association between measures of obesity and outcomes in coronary artery disease (CAD) patients. We included consecutive patients referred to cardiac rehabilitation for previous CAD events, who were classified using body mass index (BMI) groups and gender-specific tertiles of waist-to-hip ratio (WHR). Follow-up was ascertained using a population-based, record linkage system. Major cardiovascular event (MACE) was defined as the composite outcome including acute coronary syndromes, coronary revascularization, ventricular arrhythmias, stroke, or death from any cause. We used Cox proportional hazards models adjusted for potential confounders. The cohort included 1,529 patients (74% men), 63.1 ± 12.5 years (mean age ± SD), of whom 40% were obese by BMI. Eighty-eight percent of men and 57% of women were classified as having central obesity by WHR. Median follow-up was 5.7 years and 415 patients had MACE. After adjustment, a high WHR tertile was a significant predictor for MACE in women (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.16, 2.94, p = 0.01) but not in men (HR 0.92, 95% CI 0.69, 1.22, p = 0.54). This relation in women persisted after further adjustment for BMI (HR 1.75, 95% CI 1.07, 2.87, p = 0.03). Obesity by BMI was not associated with MACE in either men (HR 1.07, 95% CI 0.76, 1.51, p = 0.69) or women (HR 0.98, 95% CI 0.62, 1.56, p = 0.95). In conclusion, WHR is associated with a higher risk of MACE among women with CAD but not in men. There was no obesity paradox when assessing obesity by BMI in patients with CAD when including nonfatal events.
• Subjects:
  Article Cardiac Rehabilitation Coronary Artery Disease Obesity
• Source:
  Am J Cardiol. 121(8):903-909
• Pubmed ID:
  29482851
• Pubmed Central ID:
  PMC6053270
• Document Type:
  Journal Article
• Funding:
  R01 HL114024/HL/NHLBI NIH HHS/United States ; R01 AG034676/AG/NIA NIH HHS/United States ; R01 HL065176/HL/NHLBI NIH HHS/United States ; UL1 TR001086/TR/NCATS NIH HHS/United States ; U48 DP005018/DP/NCCDPHP CDC HHS/United States ; UL1 TR000135/TR/NCATS NIH HHS/United States ; U48DP005018/ACL HHS/United States ; R25 HL092621/HL/NHLBI NIH HHS/United States ; K23 AG051681/AG/NIA NIH HHS/United States
• Volume:
  121
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5929cd3de89a61cd2cefadc0691b3c2a6186f2def1c5fd9ed4079c50341f71cf
• Download URL:
  https://stacks.cdc.gov/view/cdc/57428/cdc_57428_DS1.pdf
• File Type:
  [PDF - 504.86 KB ]