Body mass index: a risk factor for unstable angina and myocardial infarction in patients with angiographically confirmed coronary artery disease.

Abstract:

BACKGROUND:In patients with coronary artery disease (CAD), acute thrombosis frequently occurs in coronary arteries with only mild or moderate stenoses. Obesity increases the risk of atherosclerosis, but it is not known whether it also increases the risk of coronary thrombosis. We hypothesized that body mass index (BMI) might be an independent predictor of an acute coronary syndrome in patients with established coronary atherosclerosis. METHODS AND RESULTS:Of 504 patients undergoing coronary angiography, those with evidence of >10% coronary artery stenoses were divided into 2 groups, with either stable (n=226) or unstable CAD (unstable angina or myocardial infarction; n=156). After adjusting for other risk factors (age, gender, blood pressure, lipid levels, insulin resistance, leptin, fibrinogen, C-reactive protein (CRP), CAD severity on angiography, smoking status, and a history of myocardial infarction or hypertension), BMI had a significant independent association with an acute coronary syndrome, with an odds ratio of 1.49 (P=0.014). This positive relation between BMI and the risk of acute coronary events was evident for even mildly elevated BMI values. Multivariate analysis also showed that CRP and the number of coronary lesions were independent predictors of risk of an acute coronary event. CONCLUSIONS:In patients with established coronary atherosclerosis, BMI, as well as CRP and number of coronary lesions, are independently associated with acute coronary syndromes. There is evidence of increased risk even at mildly elevated BMI levels.

journal_name

Circulation

journal_title

Circulation

authors

Wolk R,Berger P,Lennon RJ,Brilakis ES,Somers VK

doi

10.1161/01.CIR.0000095270.85646.E8

subject

Has Abstract

pub_date

2003-11-04 00:00:00

pages

2206-11

issue

18

eissn

0009-7322

issn

1524-4539

pii

01.CIR.0000095270.85646.E8

journal_volume

108

pub_type

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