The American Journal of Medicine
Volume 118, Issue 9 , Pages 981-990 , September 2005

Elevated body mass index and intermediate-term clinical outcomes after acute coronary syndromes

  • Eric L. Eisenstein, DBA

      Affiliations

    • Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC
    • Corresponding Author InformationRequests for reprints should be addressed to Eric L. Eisenstein, DBA, Assistant Research Professor in Medicine, Duke Clinical Research Institute, P.O. Box 3865, Durham, NC 27715.
    • ,
  • Darren K. McGuire, MD, MHS

      Affiliations

    • Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Tex
    • ,
  • Manjushri V. Bhapkar, MS

      Affiliations

    • Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC
    • ,
  • Arni Kristinsson, MD, PhD

      Affiliations

    • National University Hospital, Reykjavik, Iceland
    • ,
  • Judith S. Hochman, MD

      Affiliations

    • Division of Cardiology, St. Luke’s-Roosevelt Hospital Center, New York, NY
    • ,
  • David F. Kong, MD

      Affiliations

    • Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC
    • ,
  • Robert M. Califf, MD

      Affiliations

    • Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC
    • ,
  • Frans Van de Werf, MD, PhD

      Affiliations

    • Department of Cardiology, Gasthuisberg University Hospital, Leuven, Belgium.
    • ,
  • William S. Yancy Jr., MD, MHS

      Affiliations

    • Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC
    • ,
  • L. Kristin Newby, MD, MHS

      Affiliations

    • Duke University Medical Center and the Duke Clinical Research Institute, Durham, NC

References 

  1. Bjorntorp P . Obesity . Lancet . 1997;350:423–426
  2. The National Task Force on the Prevention and Treatment of Obesity . Overweight, obesity, and health risk . Arch Intern Med. . 2000;160:898–904
  3. Flegal KM , Carroll MD , Ogden CL , Johnson CL . Prevalence and trends in obesity among US adults, 1999–2000 . JAMA . 2002;288:1723–1727
  4. Calle EE , Thun MJ , Petrelli JM , et al.   Body-mass index and mortality in a prospective cohort of U.S. adults . N Engl J Med. . 1999;341:1097–1105
  5. Rosengren A , Wedel H , Wilhelmsen L . Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality. A prospective population study . Eur Heart J . 1999;20:269–277
  6. Eckel RH , Krauss RM  AHA Nutrition Committee . American Heart Association call to action (obesity as a major risk factor for coronary heart disease) . Circulation . 1998;97:2099–2100
  7. Eisenstein EL , Shaw LK , Nelson CL , et al.   Obesity and long-term clinical and economic outcomes in coronary artery disease patients . Obes Res. . 2002;10:83–91
  8. The SYMPHONY Investigators . Comparison of sibrafiban with aspirin for prevention of cardiovascular events after acute coronary syndromes: a randomised trial. The SYMPHONY Investigators. Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-acute Coronary Syndromes . Lancet . 2000;355:337–345
  9. The 2nd SYMPHONY Investigators . Randomized trial of aspirin, sibrafiban, or both for secondary prevention after acute coronary syndromes . Circulation . 2001;103:1727–1733
  10. Newby LK  Symphony Steering Committee . Long-term oral platelet glycoprotein IIb/IIIa receptor antagonism with sibrafiban after acute coronary syndromes (study design of the sibrafiban versus aspirin to yield maximum protection from ischemic heart events post-acute coronary syndromes (SYMPHONY) trial) . Am Heart J . 1999;138:210–218
  11. National Heart Lung and Blood Institute Obesity Education Initiative Expert Panel . Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (the Evidence Report) . Rockville, Maryland: National Heart, Lung, and Blood Institute; 1998;
  12. Newby LK , Bhapkar MV , White HD , et al.   Predictors of 90-day outcome in patients stabilized after acute coronary syndromes . Eur Heart J . 2003;24:172–181
  13. Ford ES , Giles WH , Dietz WH . Prevalence of the metabolic syndrome among US adults (findings from the third National Health and Nutrition Examination Survey) . JAMA . 2002;287:356–359
  14. Kim KS , Owen WL , Williams D , Adams-Campbell LL . A comparison between BMI and Conicity index on predicting coronary heart disease (the Framingham Heart Study) . Ann Epidemiol. . 2000;10:424–431
  15. Lakka HM , Lakka TA , Tuomilehto J , Salonen JT . Abdominal obesity is associated with increased risk of acute coronary events in men . Eur Heart J . 2002;23:706–713
  16. Rimm EB , Stampfer MJ , Giovannucci E , et al.   Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men . Am J Epidemiol. . 1995;141:1117–1127
  17. Hubert HB , Holford TR , Kannel WB . Clinical characteristics and cigarette smoking in relation to prognosis of angina pectoris in Framingham . Am J Epidemiol. . 1982;115:231–242
  18. Troiano RP , Frongillo EA , Sobal J , Levitsky DA . The relationship between body weight and mortality (a quantitative analysis of combined information from existing studies) . Int J Obes Relat Metab Disord. . 1996;20:63–75
  19. Lee IM , Manson JE , Hennekens CH , Paffenbarger RS . Body weight and mortality. A 27-year follow-up of middle-aged men . JAMA . 1993;270:2823–2828
  20. Visscher TL , Seidell JC , Menotti A , et al.   Underweight and overweight in relation to mortality among men aged 40–59 and 50–69 years (the Seven Countries Study) . Am J Epidemiol. . 2000;151:660–666
  21. Gruberg L , Weissman NJ , Waksman R , et al.   The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention (the obesity paradox?) . J Am Coll Cardiol. . 2002;39:578–584
  22. Gurm HS , Brennan DM , Booth J , et al.   Impact of body mass index on outcome after percutaneous coronary intervention (the obesity paradox) . Am J Cardiol. . 2002;90:42–45
  23. Gurm HS , Whitlow PL , Kip KE . The impact of body mass index on short- and long-term outcomes in patients undergoing coronary revascularization. Insights from the bypass angioplasty revascularization investigation (BARI) . J Am Coll Cardiol. . 2002;39:834–840
  24. Ellis SG , Elliott J , Horrigan M , et al.   Low-normal or excessive body mass index (newly identified and powerful risk factors for death and other complications with percutaneous coronary intervention) . Am J Cardiol. . 1996;78:642–646
  25. Minutello RM , Chou ET , Hong MK , et al.   Impact of body mass index on in-hospital outcomes following percutaneous coronary intervention (report from the New York State Angioplasty Registry) . Am J Cardiol. . 2004;93:1229–1232
  26. Prabhakar G , Haan CK , Peterson ED , et al.   The risks of moderate and extreme obesity for coronary artery bypass grafting outcomes (a study from the Society of Thoracic Surgeons’ database) . Ann Thorac Surg. . 2002;74:1125–1130
  27. Hoit BD , Gilpin EA , Maisel AA , et al.   Influence of obesity on morbidity and mortality after acute myocardial infarction . Am Heart J . 1987;114:1334–1341
  28. Kaplan RC , Heckbert SR , Furberg CD , Psaty BM . Predictors of subsequent coronary events, stroke, and death among survivors of first hospitalized myocardial infarction . J Clin Epidemiol. . 2002;55:654–664
  29. Alexander KP , Peterson ED , Granger CB , et al.   Potential impact of evidence-based medicine in acute coronary syndromes: insights from GUSTO-IIb. Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes trial . J Am Coll Cardiol. . 1998;32:2023–2030
  30. Alexander KP , Galanos AN , Jollis JG , et al.   Post-myocardial infarction risk stratification in elderly patients . Am Heart J . 2001;142:37–42
  31. Barakat K , Wilkinson P , Deaner A , et al.   How should age affect management of acute myocardial infarction? A prospective cohort study . Lancet . 1999;353:955–959
  32. Krumholz HM , Philbin DM , Wang Y , et al.   Trends in the quality of care for Medicare beneficiaries admitted to the hospital with unstable angina . J Am Coll Cardiol. . 1998;31:957–963
  33. Paul SD , O’Gara PT , Mahjoub ZA , et al.   Geriatric patients with acute myocardial infarction (cardiac risk factor profiles, presentation, thrombolysis, coronary interventions, and prognosis) . Am Heart J . 1996;131:710–715
  34. Suwaidi JA , Wright RS , Grill JP , et al.   Obesity is associated with premature occurrence of acute myocardial infarction . Clin Cardiol. . 2001;24:542–547
  35. Lamon-Fava S , Wilson PW , Schaefer EJ . Impact of body mass index on coronary heart disease risk factors in men and women. The Framingham Offspring Study . Arterioscler Thromb Vasc Biol. . 1996;16:1509–1515
  36. Hubert HB , Feinleib M , McNamara PM , Castelli WP . Obesity as an independent risk factor for cardiovascular disease (a 26-year follow-up of participants in the Framingham Heart Study) . Circulation . 1983;67:968–977
  37. Alexander JK . Obesity and cardiac performance . Am J Cardiol. . 1964;14:860–865
  38. Kurien VA , Oliver MF . A metabolic cause for arrhythmias during acute myocardial hypoxia . Lancet . 1970;1:813–815
  39. Lemieux I , Pascot A , Prud’homme D , et al.   Elevated C-reactive protein (another component of the atherothrombotic profile of abdominal obesity) . Arterioscler Thromb Vasc Biol. . 2001;21:961–967
  40. Davies MJ . The pathophysiology of acute coronary syndromes . Heart . 2000;83:361–366
  41. Kannel WB . Cigarettes, coronary occlusions, and myocardial infarction . JAMA . 1981;246:871–872
  42. Barbash GI , White HD , Modan M , et al.   Significance of smoking in patients receiving thrombolytic therapy for acute myocardial infarction. Experience gleaned from the International Tissue Plasminogen Activator/Streptokinase Mortality Trial . Circulation . 1993;87:53–58
  43. Barbash GI , Reiner J , White HD , et al.   Evaluation of paradoxic beneficial effects of smoking in patients receiving thrombolytic therapy for acute myocardial infarction: mechanism of the “smoker’s paradox” from the GUSTO-I trial, with angiographic insights. Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries . J Am Coll Cardiol. . 1995;26:1222–1229
  44. Patel V , Topol EJ . Lessons from the GUSTO trials . In:  Topol EJ editors. Acute Coronary Syndromes . New York, New York: Marcel Dekker; 2001;p. 725–764
  45. Gottlieb S , Fallavollita J , McDermott M , et al.   Cigarette smoking and the age at onset of a first non-fatal myocardial infarction . Coron Artery Dis. . 1994;5:687–694
  46. Andrikopoulos GK , Richter DJ , Dilaveris PE , et al.   In-hospital mortality of habitual cigarette smokers after acute myocardial infarction; the “smoker’s paradox” in a countrywide study . Eur Heart J . 2001;22:776–784
  47. Rexrode KM , Carey VJ , Hennekens CH , et al.   Abdominal adiposity and coronary heart disease in women . JAMA . 1998;280:1843–1848
  48. Morricone L , Ferrari M , Enrini R , et al.   The role of central fat distribution in coronary artery disease in obesity (comparison of nondiabetic obese, diabetic obese, and normal weight subjects) . Int J Obes Relat Metab Disord. . 1999;23:1129–1135
  49. Wei M , Kampert JB , Barlow CE , et al.   Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men . JAMA . 1999;282:1547–1553
  50. Lee CD , Blair SN , Jackson AS . Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men . Am J Clin Nutr. . 1999;69:373–380

PII: S0002-9343(05)00103-8

doi: 10.1016/j.amjmed.2005.02.017

The American Journal of Medicine
Volume 118, Issue 9 , Pages 981-990 , September 2005

Article Tools

* Image Usage & Resolution