Document Detail

Central obesity and survival in subjects with coronary artery disease a systematic review of the literature and collaborative analysis with individual subject data.
MedLine Citation:
PMID:  21545944     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients.
BACKGROUND: The question of which measure of obesity better predicts survival in patients with CAD is controversial.
METHODS: We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months.
RESULTS: From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI ≥30 kg/m(2) (HR: 1.93, 95% CI: 1.61 to 2.32).
CONCLUSIONS: In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.
Thais Coutinho; Kashish Goel; Daniel Corrêa de Sá; Charlotte Kragelund; Alka M Kanaya; Marianne Zeller; Jong-Seon Park; Lars Kober; Christian Torp-Pedersen; Yves Cottin; Luc Lorgis; Sang-Hee Lee; Young-Jo Kim; Randal Thomas; Véronique L Roger; Virend K Somers; Francisco Lopez-Jimenez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  57     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1877-86     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Department of Medicine, Mayo Clinic, Rochester, Minnesota; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
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