Obesity, metabolic syndrome and cardiovascular prognosis: From the Partners coronary computed tomography angiography registry

Edward A. Hulten, Marcio Sommer Bittencourt, Ryan Preston, Avinainder Singh, Carla Romagnolli, Brian Ghoshhajra, Ravi Shah, Siddique Abbasi, Suhny Abbara, Khurram Nasir, Michael Blaha, Udo Hoffmann, Marcelo F. Di Carli, Ron Blankstein

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.

Original languageEnglish (US)
Article number14
JournalCardiovascular Diabetology
Volume16
Issue number1
DOIs
StatePublished - Jan 25 2017

Fingerprint

Metabolic Syndrome X
Registries
Body Mass Index
Obesity
Coronary Artery Disease
Statistical Models
Cohort Studies
Retrospective Studies
Computed Tomography Angiography

Keywords

  • Cohort
  • Coronary artery disease
  • Coronary computed tomography angiography
  • Metabolic syndrome
  • Obesity
  • Prognosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

Hulten, E. A., Bittencourt, M. S., Preston, R., Singh, A., Romagnolli, C., Ghoshhajra, B., ... Blankstein, R. (2017). Obesity, metabolic syndrome and cardiovascular prognosis: From the Partners coronary computed tomography angiography registry. Cardiovascular Diabetology, 16(1), [14]. https://doi.org/10.1186/s12933-017-0496-8

Obesity, metabolic syndrome and cardiovascular prognosis : From the Partners coronary computed tomography angiography registry. / Hulten, Edward A.; Bittencourt, Marcio Sommer; Preston, Ryan; Singh, Avinainder; Romagnolli, Carla; Ghoshhajra, Brian; Shah, Ravi; Abbasi, Siddique; Abbara, Suhny; Nasir, Khurram; Blaha, Michael; Hoffmann, Udo; Di Carli, Marcelo F.; Blankstein, Ron.

In: Cardiovascular Diabetology, Vol. 16, No. 1, 14, 25.01.2017.

Research output: Contribution to journalArticle

Hulten, EA, Bittencourt, MS, Preston, R, Singh, A, Romagnolli, C, Ghoshhajra, B, Shah, R, Abbasi, S, Abbara, S, Nasir, K, Blaha, M, Hoffmann, U, Di Carli, MF & Blankstein, R 2017, 'Obesity, metabolic syndrome and cardiovascular prognosis: From the Partners coronary computed tomography angiography registry', Cardiovascular Diabetology, vol. 16, no. 1, 14. https://doi.org/10.1186/s12933-017-0496-8
Hulten, Edward A. ; Bittencourt, Marcio Sommer ; Preston, Ryan ; Singh, Avinainder ; Romagnolli, Carla ; Ghoshhajra, Brian ; Shah, Ravi ; Abbasi, Siddique ; Abbara, Suhny ; Nasir, Khurram ; Blaha, Michael ; Hoffmann, Udo ; Di Carli, Marcelo F. ; Blankstein, Ron. / Obesity, metabolic syndrome and cardiovascular prognosis : From the Partners coronary computed tomography angiography registry. In: Cardiovascular Diabetology. 2017 ; Vol. 16, No. 1.
@article{2e3d2c5532f64fb682e99b600a04deb9,
title = "Obesity, metabolic syndrome and cardiovascular prognosis: From the Partners coronary computed tomography angiography registry",
abstract = "Objective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50{\%}), or obstructive CAD (≥50{\%}) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.",
keywords = "Cohort, Coronary artery disease, Coronary computed tomography angiography, Metabolic syndrome, Obesity, Prognosis",
author = "Hulten, {Edward A.} and Bittencourt, {Marcio Sommer} and Ryan Preston and Avinainder Singh and Carla Romagnolli and Brian Ghoshhajra and Ravi Shah and Siddique Abbasi and Suhny Abbara and Khurram Nasir and Michael Blaha and Udo Hoffmann and {Di Carli}, {Marcelo F.} and Ron Blankstein",
year = "2017",
month = "1",
day = "25",
doi = "10.1186/s12933-017-0496-8",
language = "English (US)",
volume = "16",
journal = "Cardiovascular Diabetology",
issn = "1475-2840",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Obesity, metabolic syndrome and cardiovascular prognosis

T2 - From the Partners coronary computed tomography angiography registry

AU - Hulten, Edward A.

AU - Bittencourt, Marcio Sommer

AU - Preston, Ryan

AU - Singh, Avinainder

AU - Romagnolli, Carla

AU - Ghoshhajra, Brian

AU - Shah, Ravi

AU - Abbasi, Siddique

AU - Abbara, Suhny

AU - Nasir, Khurram

AU - Blaha, Michael

AU - Hoffmann, Udo

AU - Di Carli, Marcelo F.

AU - Blankstein, Ron

PY - 2017/1/25

Y1 - 2017/1/25

N2 - Objective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.

AB - Objective: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). Methods: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models. Results: Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events. Conclusions: Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.

KW - Cohort

KW - Coronary artery disease

KW - Coronary computed tomography angiography

KW - Metabolic syndrome

KW - Obesity

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85011004593&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011004593&partnerID=8YFLogxK

U2 - 10.1186/s12933-017-0496-8

DO - 10.1186/s12933-017-0496-8

M3 - Article

C2 - 28122619

AN - SCOPUS:85011004593

VL - 16

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

SN - 1475-2840

IS - 1

M1 - 14

ER -