Document Detail

Severity of coronary artery disease in obese patients undergoing coronary angiography: "obesity paradox" revisited.
MedLine Citation:
PMID:  17680619     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent studies have highlighted the existence of an 'obesity paradox' in patients undergoing coronary angiography, i.e., a high body mass Index (BMI) is associated with less severe coronary lesions. We sought to confirm the existence of this phenomenon in the US patient population. METHODS: Study subjects included 770 consecutive patients (470 men, 428 African-Americans, 212 Caucasians) referred for coronary angiography to a tertiary care center. Duke myocardial jeopardy score, a prognostication tool predictive of 1-year mortality in coronary artery disease (CAD) patients, was assigned to angiographic data. Patients were classified according to their BMI (kg/m2) as normal (21-24), overweight (25-29), obesity class I (30-34), class II (35-39) and class III (40 or above). RESULTS: Patients in the increasing obesity class had a higher prevalence of diabetes, hypertension and dyslipidemia and were more likely to be women. A negative correlation was observed between BMI and age (R = - 0.15 p < 0.001) as well as between BMI and Duke Jeopardy score (r = - 0.07, p < 0.05) indicating that patients with higher BMI were referred for coronary angiography at a younger age, and had a lower coronary artery disease (CAD) burden. BMI was not an independent predictor of coronary lesion severity on multivariate stepwise linear regression analysis. CONCLUSION: Obese patients are referred for coronary angiography at an earlier age and have a lower CAD burden lending further credence to the existence of an apparent "obesity paradox". However, obesity per se, after adjustment for comorbidities, is not an independent predictor of severity of coronary artery disease.
Ashutosh Niraj; Jyotiranjan Pradhan; Jyotiranjan Pradahan; Hesham Fakhry; Vikas Veeranna; Luis Afonso
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  30     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-13     Completed Date:  2008-03-21     Revised Date:  2008-08-31    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  391-6     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley Periodicals, Inc.
Department of Internal Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan, USA.
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MeSH Terms
Aged, 80 and over
Body Mass Index
Coronary Angiography*
Coronary Artery Disease / epidemiology,  etiology*,  radiography*
Linear Models
Middle Aged
Multivariate Analysis
Obesity / complications*
Predictive Value of Tests
Research Design
Risk Factors
Severity of Illness Index
United States / epidemiology
Erratum In:
Clin Cardiol. 2008 Aug;31(8):392
Note: Pradahan, Jyotiranjan [corrected to Pradhan, Jyotiranjan]

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