TY - JOUR
T1 - Clustering of metabolic abnormalities among obese patients and mortality after percutaneous coronary intervention
AU - Bashey, Sameer
AU - Muntner, Paul
AU - Kini, Annapoorna S.
AU - Esquitin, Ricardo
AU - Razzouk, Louai
AU - Mathewkutty, Shiny
AU - Wildman, Rachel P.
AU - Carson, April P.
AU - Kim, Michael C.
AU - Moreno, Pedro R.
AU - Sharma, Samin K.
AU - Farkouh, Michael E.
N1 - Funding Information:
This study was funded through internal resources from Mount Sinai Cardiac Catheterization Laboratory , New York, New York. Dr. Sharma has served on speaker bureaus for Eli Lilly, Boston Scientific, Abbott Vascular, and the Medicines Company. Coronary artery disease
PY - 2011/5/15
Y1 - 2011/5/15
N2 - 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/m2 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/m2, respectively. In patients with BMI of 30.0 to 34.9 kg/m2, 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/m2 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/m2, respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m2 were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
AB - 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/m2 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/m2, respectively. In patients with BMI of 30.0 to 34.9 kg/m2, 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/m2 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/m2, respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m2 were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
UR - https://www.scopus.com/pages/publications/79955615257
U2 - 10.1016/j.amjcard.2011.01.012
DO - 10.1016/j.amjcard.2011.01.012
M3 - Article
C2 - 21420054
AN - SCOPUS:79955615257
SN - 0002-9149
VL - 107
SP - 1415
EP - 1420
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 10
ER -