Document Detail


Relation of exercise capacity and body mass index to mortality in patients with intermediate to high risk of coronary artery disease.
MedLine Citation:
PMID:  18929704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relative impact of body mass index (BMI) and exercise capacity on mortality in patients with an intermediate to high likelihood of coronary artery disease (CAD) is not clear. Thus, the effect of BMI and exercise capacity on all-cause mortality in patients referred for stress myocardial perfusion imaging was investigated. The outcome of 2,119 patients undergoing exercise stress myocardial perfusion imaging from 1995 to 1999 was assessed. Patients lacked known CAD, but were at intermediate to high risk. Mortality outcome data were obtained from the Social Security Administration Death Master File. There were 183 deaths during an average follow-up of 8.4 +/- 1.4 years. A Cox proportional hazards model identified age, Bruce protocol exercise time, BMI, male gender, and diabetes mellitus as significant predictors of all-cause mortality. In multivariate analysis, both exercise capacity and BMI correlated inversely with mortality, with higher chi-squared impact related to exercise capacity than BMI. In conclusion, both increased exercise capacity and BMI were associated with lower mortality in patients with an intermediate to high likelihood of CAD after controlling for confounding variables, supporting an inverse impact of BMI on mortality. The origin for this "obesity paradox" is unclear.
Authors:
Nils P Johnson; Edwin Wu; Robert O Bonow; Thomas A Holly
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-31
Journal Detail:
Title:  The American journal of cardiology     Volume:  102     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1028-33     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. n-johnson4@md.northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Body Mass Index*
Coronary Angiography
Coronary Disease / diagnosis,  mortality*,  physiopathology*
Electrocardiography
Exercise Test / methods
Exercise Tolerance / physiology*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate
Tomography, Emission-Computed, Single-Photon

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


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