Impact of Overweight/Obesity on Clinical Outcomes of Patient with Vasospastic Angina: From the Vasospastic Angina in Korea Registry

Abstract

obesity is associated with a high risk of morbidity and mortality in the general population and is a major independent risk factor for cardiovascular disease. We sought to evaluate the effect of overweight/ obesity on clinical outcomes of patients with vasospastic angina (VA) at 1-year follow-up. The VA-KOREA (Vasospastic Angina in Korea) registry was a cohort of 11 centers from 2010 to 2015. The primary endpoint was a composite of cardiac death (cD), new-onset arrhythmia, and acute coronary syndrome (ACS). Using the body mass index (BMI) cut-off for Asians, 517 patients with definite VA were divided into either an overweight/obese (BMi ≥ 23 kg/m 2 ) group (n = 378) or a normal weight (BMI 18.5-22.9 kg/m 2 ) group (n = 139). The overweight/obese group showed a significantly lower rate of the primary endpoint composite (2.4% vs 7.9%, p = 0.004) and ACS (0.8% vs 4.3%, p = 0.007) than the normal weight group in the crude population. Similarly, in propensity-score matched analysis, the overweight/obese group showed a significantly lower rate of the primary endpoint composite (2.3% vs 8.4%, p = 0.006) and ACS (1.1% vs 4.6%, p = 0.035) than the normal weight group. However, there were no significant differences in CD and new-onset arrhythmia between the two groups in both the crude and propensity-score matched population. independent predictors of the primary endpoint were overweight/obesity and dyslipidemia. in patients with VA, the overweight/obese group was associated with a favorable 1-year primary endpoint and the difference was mainly driven by the lower rate of ACS compared with the normal weight group.

Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis

“…Study data were obtained from a nationwide prospective Vasospastic Angina in Korea (VA-Korea) registry. The study design of VA-Korea has been published previously [6,14,15]. Eleven tertiary hospitals in Korea participated in this registry between May 2010 and June 2015.…”

Association of obesity with diabetic retinopathy in US adults with diabetes in a national survey

“…In Australian DMP study, overweight was defined as BMI 25–29.9 kg/m 2 and obesity was defined as BMI >30 kg/m 2 ( 8 ). In the Indian SN-DREAMS-I study, obesity was defined as BMI ≥23 kg/m 2 ( 16 ), which in some studies on the Asian population, was defined as overweight ( 21 , 22 ), referring to both the overweight and the obesity populations. Moreover, the mean BMI of patients included in different studies is also varied due to different populations and races.…”

Current Evidence on Long-Term Prognostic Factors in Vasospastic Angina

“…Several clinical variables that are suggested as long-term prognostic factors in some studies require further investigation to confirm their roles in VSA. [5,9,35,45,46] Age [18][19][20] Obesity [22,30] Sex [16,22,26] Organic stenosis [5,13,17,22,24,37] Smoking [34][35][36]38] Alcohol [29,41] Aspirin [74][75][76][77] Definite spasm [17,52] Long-acting nitrate (harmful) [55,[64][65][66] ** Traditional risk factors [14,18,29] Table 1. Cont.…”

“…In the nation-wide prospective registry of patients with VSA in Korea (VA-KOREA registry), overweight or obesity was associated with a lower occurrence of clinical events during a 1-year follow-up of VSA patients compared to patients with normal body weight, and the authors suggested the existence of an “obesity paradox” in VSA [ 30 ]. Kim et al showed that obesity (body mass index ≥ 25 kg/m 2 ) was associated with a better prognosis in female VSA patients; however, this association was not observed in male VSA patients [ 31 ].…”