Vascular Regenerative Capacity and the Obesity Paradox in Coronary Artery Disease

Mehta, Anurag; Meng, Qi; Li, Xiaona; Desai, Shivang; D'Souza, Melroy; Ho, Annie; Islam, Shabatun; Dhindsa, Devinder S.; Almuwaqqat, Zakaria; Nayak, Aditi; Alkhoder, Ayman; Hooda, Ananya; Varughese, Anil; Ahmad, Syed Furquan; Mokhtari, Ali Mohammad; Hesaroieh, Iraj; Sperling, Laurence; Ko, Yi‐An; Waller, Edmund K.; Quyyumi, Arshed A.

doi:10.1161/atvbaha.120.315703

Cited by 10 publications

(13 citation statements)

References 47 publications

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“…But interestingly, through big data analysis, it can be found that there is no nonlinear relationship between the degree of obesity and atherosclerosis. Studies have shown that when CPC is used as an index of endogenous vascular proliferation to study this paradox, the number of good outcomes of high regenerative capacity (i.e., high CPC count) in obese people is more [ 80 ]. On the other hand, the degree of visceral obesity and BMI index is not linear [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

Recent Progress of Chronic Stress in the Development of Atherosclerosis

Gao

Wang

Meng

et al. 2022

Oxidative Medicine and Cellular Longevity

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With the development of the times, cardiovascular diseases have become the biggest cause of death in the global aging society, causing a serious social burden. Atherosclerosis is a chronic inflammatory disease, which can occur in large and medium-sized blood vessels in the whole body. It takes atherosclerotic plaque as the typical pathological change and endothelial injury as the core pathophysiological mechanism. It is the pathological basis of coronary heart disease, peripheral artery disease, cerebrovascular disease, and other diseases. Recent studies have shown that chronic stress plays an important role in the occurrence and development of atherosclerosis, endothelial injury, lipid metabolism, and chronic inflammation. This process involves a large number of molecular targets. It is usually the cause of atherosclerotic cardiovascular and cerebrovascular diseases. If chronic stress factors exist for a long time, patients have genetic susceptibility, and the combination of environmental factors triggers the pathogenesis, which may eventually lead to complete blockage of the blood vessels, unstable rupture of plaques, and serious adverse cardiovascular events. This paper reviews the role of chronic stress in the occurrence and development of atherosclerosis, focusing on the pathophysiological mechanism.

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Section: Resultsmentioning

confidence: 99%

Recent Progress of Chronic Stress in the Development of Atherosclerosis

Gao

Wang

Meng

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Other potential mechanisms include lower activation of the sympathetic nervous system ( 43 ) and higher circulating progenitor cell (CPC) counts ( 44 ) in obesity patients. It has been proved that persisting activation of the sympathetic nervous system will lead to poor prognosis of HF ( 45 ).…”

Section: Discussionmentioning

confidence: 99%

“…CPCs are mononuclear cells that related to an endogenous regenerative or reparative system, contributing to vascular repair as well as regeneration ( 47 ). While obesity was independently associated with higher CPC counts, which may indicate a better prognosis ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between Obesity and Lower Short- and Long-Term Mortality in Coronary Care Unit Patients: A Cohort Study of the MIMIC-III Database

Yan

Yuan

et al. 2022

Front. Endocrinol.

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IntroductionObesity has long been considered an independent risk factor for cardiovascular diseases (CVD), even in the COVID-19 pandemic. However, recent studies have found that a certain degree of obesity may be beneficial for patients who have already suffered from CVD, which is called the “obesity paradox”. Our objective was to investigate whether the obesity paradox existed in coronary care unit (CCU) patients and the relationship between body mass index (BMI) and short- and long-term mortality.MethodsWe performed a cohort analysis of 3,502 adult CCU patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database. The patients were divided into four groups according to the WHO BMI categories. Both multivariable logistic regression and Cox regression were used to reveal the relation between BMI and mortality. Subgroup analyses were performed based on Simplified Acute Physiology Score (SAPS) and age.ResultsAfter adjusting for confounders, obese patients had 33% and 30% lower mortality risk at 30-day and 1-year (OR 0.67, 95% CI 0.51 to 0.89; HR 0.70, 95% CI 0.59 to 0.83; respectively) compared with normal-weight patients, while the underweight group were opposite, with 141% and 81% higher in short- and long-term (OR 2.41, 95% CI 1.37 to 4.12; HR 1.81, 95% CI 1.34 to 2.46; respectively). Overweight patients did not have a significant survival advantage at 30-day (OR 0.91, 95% CI 0.70 to 1.17), but did have a 22% lower mortality risk at 1-year (HR 0.78; 95% CI 0.67 to 0.91). The results were consistent after being stratified by SAPS and age.ConclusionOur study supports that obesity improved survival at both 30-day and 1-year after CCU admission, and the obesity paradox existed in CCU patients.

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“…Increased muscle strength in obesity has also been associated with a better prognosis [ 12 ].In this evaluation of the obesity paradox, BMI is a protective factor in both lower and higher CRP groups [ 23 ]. In obese people with CAD, endogenous regenerative capacity can be measured by using cell progenitor counts, which also explains this obesity paradox [ 6 ]. The relation of obesity with adverse outcomes in CAD is indirectly proportional to those with a preserved endogenous regenerative capacity which is higher cell progenitor cell counts [ 6 ].…”

Section: Reviewmentioning

confidence: 99%

“…The risks of developing CAD increased by 40% with every 10 cm rise in waist circumference, with an odds ratio of 1.04 (95% CI: 1.01-1.07, P = 0.013) for a 1 cm increment [ 4 ]. The obesity paradox has been seen in some patient populations, but the pathophysiologic mechanisms causing it are not fully understood [ 6 ]. Metabolically healthy obesity (MHO) is one type of obesity without any cardiometabolic risk factors such as hypertension, dyslipidemia, insulin resistance, and type 2 diabetes mellitus [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Obesity and Coronary Artery Disease: An Updated Systematic Review 2022

Manoharan¹,

Raja²,

Jamil³

et al. 2022

Cureus

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The primary goal is to identify the pathogenesis of cardiovascular illnesses in obese patients. Articles were extracted using the MeSH search approach from PubMed and Google Scholar databases. Inclusion and exclusion criteria were used, and duplicates were eliminated. Eight publications were finally included in this research study after two authors independently completed the quality check appraisal. Seven observational studies and one narrative review were found in our search. The publications evaluated the risk of coronary artery disease in metabolically healthy obese people with that of unhealthy obese adults and evaluated the effects of adipose tissue-mediated inflammation. Additionally, they offered several explanations for the obesity problem. Studies have indicated that adipocytokines and their pro-inflammatory cytokines have significantly affected the development of cardiovascular disease in obese subjects. The relationship between metabolically unhealthy people with increased risk for coronary artery disease (CAD) is unclear. It has also been shown that metabolically healthy obese persons are still at risk for developing coronary artery disease (CAD), as explained in certain studies in which inflammation plays a vital role in obese people. There hasn't been much data on the advantages of being physically active in overweight people, but obese people have to change their lifestyle as a first measure.

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Vascular Regenerative Capacity and the Obesity Paradox in Coronary Artery Disease

Cited by 10 publications

References 47 publications

Recent Progress of Chronic Stress in the Development of Atherosclerosis

Recent Progress of Chronic Stress in the Development of Atherosclerosis

Association Between Obesity and Lower Short- and Long-Term Mortality in Coronary Care Unit Patients: A Cohort Study of the MIMIC-III Database

Obesity and Coronary Artery Disease: An Updated Systematic Review 2022

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