Clustering of Metabolic Abnormalities Among Obese Patients and Mortality After Percutaneous Coronary Intervention

被引：8

作者：

Bashey, Sameer ^{[1
]}

Muntner, Paul ^{[2
]}

Kini, Annapoorna S. ^{[1
]}

Esquitin, Ricardo ^{[1
]}

Razzouk, Louai ^{[1
]}

Mathewkutty, Shiny ^{[1
]}

Wildman, Rachel P. ^{[3
]}

Carson, April P. ^{[2
]}

Kim, Michael C. ^{[1
]}

Moreno, Pedro R. ^{[1
]}

Sharma, Samin K. ^{[1
]}

Farkouh, Michael E. ^{[1
,4
,5
]}

机构：

[1] Mt Sinai Cardiovasc Inst, New York, NY 10029 USA

[2] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA

[3] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA

[4] Univ Toronto, Peter Munk Cardiac Ctr, Toronto, ON, Canada

[5] Univ Toronto, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2011年 / 107卷 / 10期

关键词：

BODY-MASS INDEX; ACUTE MYOCARDIAL-INFARCTION; LONG-TERM OUTCOMES; ARTERY-DISEASE; CARDIOVASCULAR-DISEASE; STATIN THERAPY; RISK-FACTOR; IMPACT; PARADOX; REVASCULARIZATION;

D O I：

10.1016/j.amjcard.2011.01.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Although current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.5 to 24.9, 25.0 to 29.9, 30.0 to 34.9, and >= 35 kg/m(2) and by number of metabolic abnormalities possessed (hypertension, impaired fasting glucose/diabetes, triglycerides >= 150 mg/dl, high-density lipoprotein cholesterol <40 mg/dl, and C-reactive protein >= 2.0 mg/L). All- cause mortality was assessed through June 30, 2007. Mean age of patients was 65.9 years and 66% were men. Prevalences of 4 or 5 metabolic abnormalities were 12%, 18%, 24%, and 31% in patients with BMI levels of 18.5 to 24.9, 25.0 to 29.9, 30 to 34.9, and >= 35 kg/m(2), respectively. In patients with BMI of 30.0 to 34.9 kg/m(2), hazard ratios (95% confidence intervals) for mortality associated with 2, 3, and 4 to 5 metabolic abnormalities versus 0 to 1 metabolic abnormality were 1.31 (0.79 to 2.17), 1.42 (0.83 to 2.43), and 2.39 (1.24 to 4.59), respectively. Analogous hazard ratios for patients with BMI >= 35 kg/m(2) were 1.94 (0.90 to 4.20), 1.44 (0.63 to 3.28), and 2.17 (0.91 to 5.18). All-cause mortality rates per 1,000 person-years were 55.5, 33.7, 28.3, and 33.8 in patients with BMI levels of 18.5 to 24.9, 25 to 29.9, 30 to 34.9, and >= 35 kg/m(2), respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m(2) were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:1415-1420)

引用

页码：1415 / 1420

页数：6

共 30 条

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