Influence of Body Mass Index on Long-Term Survival After Cardiac Catheterization

Zafrir, Barak; Jaffe, Ronen; Rubinshtein, Ronen; Karkabi, Basheer; Flugelman, Moshe Y.; Halon, David A.

doi:10.1016/j.amjcard.2017.09.028

Cited by 12 publications

(5 citation statements)

References 28 publications

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“…There is growing evidence that obesity is a major risk factor for most cardiovascular diseases 12) . However, in many recent studies, it has been shown that patients with overweight and obesity have a better prognosis than lean patients with the same cardiovascular diseases [13][14] . This paradoxical process is called the "obesity paradox," and Lavie et al have reported the inverse relationship between lean body mass index and their prognosis in a study of patients with stable coronary heart disease 14) .…”

Section: Disclosurementioning

confidence: 99%

Decreased Appendicular Skeletal Muscle Mass is Associated with Poor Outcomes after ST-Segment Elevation Myocardial Infarction

Sato

Akiyama

Konishi

et al. 2020

JAT

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The importance of sarcopenia in cardiovascular diseases has been recently demonstrated. This study aims to examine whether skeletal muscle mass (SMM), an important component of sarcopenia, is associated with an increased risk of poor outcome in patients after ST-segment elevation myocardial infarction (STEMI). Methods: We measured SMM in 387 patients with STEMI using dual-energy X-ray absorptiometry. Patients were divided into low-and high-appendicular skeletal mass index (ASMI: appendicular SMM divided by height squared (kg/m 2)) groups using the first quartile of ASMI (≤ 6.64 kg/m 2 for men and ≤ 5.06 kg/m 2 for women). All patients were followed up for the primary composite outcome of all-cause death, nonfatal myocardial infarction, nonfatal ischemic stroke, hospitalization for congestive heart failure, and unplanned revascularization. Results: Low-ASMI group was older and had a more complex coronary lesion, a lower left ventricular ejection fraction, and a higher prevalence of Killip classification ≥ 2 than high-ASMI group. During a median follow-up of 33 months, the event rate was significantly higher in low-ASMI group than in high-ASMI group (24.7% vs 13.4%, log-rank p 0.001). Even after adjustment for patients' background, low ASMI was independently associated with the high risk of primary composite events (adjusted hazard ratio 2.06, 95% confidence interval 1.01-4.19, p 0.04). In the subgroup analyses of male patients (n 315), the optimal cutoff point of ASMI for predicting primary composite outcome was 6.75 kg/m 2 , which was close to its first quartile value. Conclusions: Low ASMI is independently associated with poor outcome in patients with STEMI.

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Section: Disclosurementioning

confidence: 99%

Decreased Appendicular Skeletal Muscle Mass is Associated with Poor Outcomes after ST-Segment Elevation Myocardial Infarction

Sato

Akiyama

Konishi

et al. 2020

JAT

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“…Unlike women, there was no significant difference between the higher and lower BMI groups in the rate of chest pain presentation in men. In previous studies, the incidence of risk factors, such as hypertension, diabetes, and hyperlipidemia, was high in obese patients [ 7 , 12 ] . Some obesity-related factors, such as mild chronic inflammation, insulin resistance and ectopic fat deposition, increase the myocardial load and cardiac metabolic stress and cause hemodynamic side effects, thereby increasing the atherothrombotic risk in overweight patients [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the impact of body mass index on outcomes of coronary artery disease in Koreans

Kim,

Lim,

Moon

et al. 2024

Coronary Artery Disease

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Background Obesity is often considered a risk factor for cardiovascular disease, but recent studies have shown conflicting results regarding the effect of BMI on the prognosis of coronary artery disease (CAD). This study aimed to evaluate the relationship between BMI and clinical outcomes of CAD according to sex in a Korean population. Methods A total of 3476 patients with a significant CAD who underwent percutaneous coronary intervention (PCI) were enrolled. Patients were classified as follows according to BMI using the Asia–Pacific cutoff points: underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2) and obese (≥25 kg/m2) patients. Underweight and normal weight patients were further categorized into the lower BMI group, whereas overweight and obese patients were categorized into the higher BMI group. The primary endpoint was all-cause mortality. Results Among women, the higher BMI group showed poor clinical features in the prevalence of hypertension and chest pain presentation, and among men, the higher BMI group had a significantly lower rate of chronic renal failure. At the end of the follow-up period (median 53.5 months), the all-cause mortality rate was lower in the higher BMI group in men, and cardiovascular death and stroke rates were significantly lower in the higher BMI group in women. Conclusion In Korean CAD patients treated with PCI, inverse correlations were observed between the clinical outcomes and BMI, but there were differences between men and women.

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“…This could explain the so-called "obesity paradox" where higher body mass index (BMI) is associated with longer survival among those with CHD, despite higher BMI being associated with shorter survival in the general population. Indeed, lower levels of other risk factors for CHD measured in individuals with high BMI may be sufficient to induce an association of higher BMI with longer survival [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Strategies to investigate and mitigate collider bias in genetic and Mendelian randomisation studies of disease progression

et al. 2023

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Genetic studies of disease progression can be used to identify factors that may influence survival or prognosis, which may differ from factors that influence on disease susceptibility. Studies of disease progression feed directly into therapeutics for disease, whereas studies of incidence inform prevention strategies. However, studies of disease progression are known to be affected by collider (also known as “index event”) bias since the disease progression phenotype can only be observed for individuals who have the disease. This applies equally to observational and genetic studies, including genome-wide association studies and Mendelian randomisation (MR) analyses. In this paper, our aim is to review several statistical methods that can be used to detect and adjust for index event bias in studies of disease progression, and how they apply to genetic and MR studies using both individual- and summary-level data. Methods to detect the presence of index event bias include the use of negative controls, a comparison of associations between risk factors for incidence in individuals with and without the disease, and an inspection of Miami plots. Methods to adjust for the bias include inverse probability weighting (with individual-level data), or Slope-Hunter and Dudbridge et al.’s index event bias adjustment (when only summary-level data are available). We also outline two approaches for sensitivity analysis. We then illustrate how three methods to minimise bias can be used in practice with two applied examples. Our first example investigates the effects of blood lipid traits on mortality from coronary heart disease, while our second example investigates genetic associations with breast cancer mortality.

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Influence of Body Mass Index on Long-Term Survival After Cardiac Catheterization

Cited by 12 publications

References 28 publications

Decreased Appendicular Skeletal Muscle Mass is Associated with Poor Outcomes after ST-Segment Elevation Myocardial Infarction

Decreased Appendicular Skeletal Muscle Mass is Associated with Poor Outcomes after ST-Segment Elevation Myocardial Infarction

Sex differences in the impact of body mass index on outcomes of coronary artery disease in Koreans

Strategies to investigate and mitigate collider bias in genetic and Mendelian randomisation studies of disease progression

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