Document Detail


Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI.
MedLine Citation:
PMID:  20300906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: While obesity has been shown to be associated with a worse mortality, an "obesity paradox"--lower mortality in obese patients--has been noted among many patients with coronary artery disease (CAD). The extent to which an obesity paradox operates among patients with only suspected CAD, is not well determined. METHODS AND RESULTS: A total of 3,673 patients (60 +/- 13 years, 36% males) with no history of heart disease and a normal stress SPECT were included in this study. Normal weight was defined as BMI of 18.5-24.9 kg x m(2); overweight 25-29.9 kg . m(2), obese >30 kg x m(2). The baseline clinical risk factors were recorded for each patient. The end point of the study was all-cause mortality. Of patients 942 (26%) were normal weight, 1,261 (34%) were overweight, and 1,470 (40%) were obese. Mean patient follow-up was 7.5 +/- 3 years. When compared to normal weight patients (event rate 3.2%/year), there was a lower incidence of death in the overweight (event rate 1.5%/year, P < .0001) and the obese (event rate 1.2%/year, P < .0001) groups. After controlling for baseline risk factors, using a reference HR = 1 for normal weight patients, there was a lower risk of death in the overweight (HR = .54, 95% CI .43-.7) and the obese groups (HR = .49, 95% CI .38-.63). CONCLUSION: In patients without known cardiac disease and a normal stress SPECT, overweight and obese patients had a lower rate of all-cause mortality compared to normal weight patients over long-term follow-up. This study substantially extends the spectrum of patients in whom the obesity paradox is present.
Authors:
Seth Uretsky; Azhar Supariwala; Padmakshi Singh; Prashanth Atluri; Surinder S Khokhar; Hari K Koppuravuri; Rajeev Joshi; Anupa Mandeva; Alan Rozanski
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Publication Detail:
Type:  Journal Article     Date:  2010-03-19
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  17     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-11     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-7     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, St. Luke's and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, New York, NY, USA. suretsky@chpnet.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Weight*
Coronary Artery Disease / complications,  mortality
Exercise Test*
Female
Humans
Male
Obesity / complications
Overweight / complications
Prognosis
Radiopharmaceuticals / diagnostic use
Rest
Risk Factors
Survival Analysis
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi
Comments/Corrections
Comment In:
J Nucl Cardiol. 2010 Jun;17(3):350-3   [PMID:  20379860 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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