Body mass index and the prevalence, severity, and risk of coronary artery disease: An international multicentre study of 13 874 patients

Troy M. Labounty, Millie J. Gomez, Stephan Achenbach, Mouaz Al-Mallah, Daniel S. Berman, Matthew J. Budoff, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Victor Cheng, Kavitha M. Chinnaiyan, Benjamin Chow, Ricardo Cury, Augustin Delago, Allison Dunning, Gudrun Feuchtner, Martin Hadamitzky, Jorg Hausleiter, Philipp Kaufmann, Yong Jin KimJonathon Leipsic, Fay Y. Lin, Erica Maffei, Gilbert Raff, Leslee J. Shaw, Todd C. Villines, James K. Min

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Abstract

AimsObesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA).Methods and resultsWe evaluated 13 874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m2), normal (20.1-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m2, 95% confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m2, 95% CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m2, 95% CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m2, 95% CI: 1.12-1.45, P < 0.001).ConclusionsAmongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction.

Original languageEnglish
Pages (from-to)456-463
Number of pages8
JournalEuropean heart journal cardiovascular Imaging
Volume14
Issue number5
DOIs
Publication statusPublished - 2013 May 1

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Multicenter Studies
Coronary Artery Disease
Body Mass Index
Myocardial Infarction
Confidence Intervals
Angiography
Thinness
Odds Ratio
Mortality
Hyperlipidemias
Registries
Pathologic Constriction
Hypertension
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Labounty, Troy M. ; Gomez, Millie J. ; Achenbach, Stephan ; Al-Mallah, Mouaz ; Berman, Daniel S. ; Budoff, Matthew J. ; Cademartiri, Filippo ; Callister, Tracy Q. ; Chang, Hyuk Jae ; Cheng, Victor ; Chinnaiyan, Kavitha M. ; Chow, Benjamin ; Cury, Ricardo ; Delago, Augustin ; Dunning, Allison ; Feuchtner, Gudrun ; Hadamitzky, Martin ; Hausleiter, Jorg ; Kaufmann, Philipp ; Kim, Yong Jin ; Leipsic, Jonathon ; Lin, Fay Y. ; Maffei, Erica ; Raff, Gilbert ; Shaw, Leslee J. ; Villines, Todd C. ; Min, James K. / Body mass index and the prevalence, severity, and risk of coronary artery disease : An international multicentre study of 13 874 patients. In: European heart journal cardiovascular Imaging. 2013 ; Vol. 14, No. 5. pp. 456-463.
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title = "Body mass index and the prevalence, severity, and risk of coronary artery disease: An international multicentre study of 13 874 patients",
abstract = "AimsObesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA).Methods and resultsWe evaluated 13 874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m2), normal (20.1-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10{\%} vs. 12 vs. 19{\%}), hypertension (37 vs. 40{\%} vs. 46 vs. 59{\%}), and hyperlipidaemia (48 vs. 52{\%} vs. 56 vs. 56{\%}; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m2, 95{\%} confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50{\%} stenosis) CAD (OR: 1.13 per +5 kg/m2, 95{\%} CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m2, 95{\%} CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m2, 95{\%} CI: 1.12-1.45, P < 0.001).ConclusionsAmongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction.",
author = "Labounty, {Troy M.} and Gomez, {Millie J.} and Stephan Achenbach and Mouaz Al-Mallah and Berman, {Daniel S.} and Budoff, {Matthew J.} and Filippo Cademartiri and Callister, {Tracy Q.} and Chang, {Hyuk Jae} and Victor Cheng and Chinnaiyan, {Kavitha M.} and Benjamin Chow and Ricardo Cury and Augustin Delago and Allison Dunning and Gudrun Feuchtner and Martin Hadamitzky and Jorg Hausleiter and Philipp Kaufmann and Kim, {Yong Jin} and Jonathon Leipsic and Lin, {Fay Y.} and Erica Maffei and Gilbert Raff and Shaw, {Leslee J.} and Villines, {Todd C.} and Min, {James K.}",
year = "2013",
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doi = "10.1093/ehjci/jes179",
language = "English",
volume = "14",
pages = "456--463",
journal = "European Heart Journal Cardiovascular Imaging",
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Labounty, TM, Gomez, MJ, Achenbach, S, Al-Mallah, M, Berman, DS, Budoff, MJ, Cademartiri, F, Callister, TQ, Chang, HJ, Cheng, V, Chinnaiyan, KM, Chow, B, Cury, R, Delago, A, Dunning, A, Feuchtner, G, Hadamitzky, M, Hausleiter, J, Kaufmann, P, Kim, YJ, Leipsic, J, Lin, FY, Maffei, E, Raff, G, Shaw, LJ, Villines, TC & Min, JK 2013, 'Body mass index and the prevalence, severity, and risk of coronary artery disease: An international multicentre study of 13 874 patients', European heart journal cardiovascular Imaging, vol. 14, no. 5, pp. 456-463. https://doi.org/10.1093/ehjci/jes179

Body mass index and the prevalence, severity, and risk of coronary artery disease : An international multicentre study of 13 874 patients. / Labounty, Troy M.; Gomez, Millie J.; Achenbach, Stephan; Al-Mallah, Mouaz; Berman, Daniel S.; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk Jae; Cheng, Victor; Chinnaiyan, Kavitha M.; Chow, Benjamin; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jorg; Kaufmann, Philipp; Kim, Yong Jin; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Min, James K.

In: European heart journal cardiovascular Imaging, Vol. 14, No. 5, 01.05.2013, p. 456-463.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body mass index and the prevalence, severity, and risk of coronary artery disease

T2 - An international multicentre study of 13 874 patients

AU - Labounty, Troy M.

AU - Gomez, Millie J.

AU - Achenbach, Stephan

AU - Al-Mallah, Mouaz

AU - Berman, Daniel S.

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Callister, Tracy Q.

AU - Chang, Hyuk Jae

AU - Cheng, Victor

AU - Chinnaiyan, Kavitha M.

AU - Chow, Benjamin

AU - Cury, Ricardo

AU - Delago, Augustin

AU - Dunning, Allison

AU - Feuchtner, Gudrun

AU - Hadamitzky, Martin

AU - Hausleiter, Jorg

AU - Kaufmann, Philipp

AU - Kim, Yong Jin

AU - Leipsic, Jonathon

AU - Lin, Fay Y.

AU - Maffei, Erica

AU - Raff, Gilbert

AU - Shaw, Leslee J.

AU - Villines, Todd C.

AU - Min, James K.

PY - 2013/5/1

Y1 - 2013/5/1

N2 - AimsObesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA).Methods and resultsWe evaluated 13 874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m2), normal (20.1-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m2, 95% confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m2, 95% CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m2, 95% CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m2, 95% CI: 1.12-1.45, P < 0.001).ConclusionsAmongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction.

AB - AimsObesity is associated with the presence of coronary artery disease (CAD) risk factors and cardiovascular events. We examined the relationship between body mass index (BMI) and the presence, extent, severity, and risk of CAD in patients referred for coronary computed tomographic angiography (CCTA).Methods and resultsWe evaluated 13 874 patients from a prospective, international, multicentre registry of individuals without known CAD undergoing CCTA. We compared risk factors, CAD findings, and risk of all-cause mortality and non-fatal myocardial infarction (MI) amongst individuals with underweight (18.5-20.0 kg/m2), normal (20.1-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2) BMI. The mean follow-up was 2.4 ± 1.2 years with 143 deaths and 193 MIs. Among underweight, normal weight, overweight, and obese individuals, there was increasing prevalence of diabetes (7 vs.10% vs. 12 vs. 19%), hypertension (37 vs. 40% vs. 46 vs. 59%), and hyperlipidaemia (48 vs. 52% vs. 56 vs. 56%; P < 0.001 for trend). After multivariable adjustment, BMI was positively associated with the prevalence of any CAD [odds ratio (OR) 1.25 per +5 kg/m2, 95% confidence interval (CI): 1.20-1.30, P < 0.001] and obstructive (≥50% stenosis) CAD (OR: 1.13 per +5 kg/m2, 95% CI: 1.08-1.19, P < 0.001); a higher BMI was also associated with an increased number of segments with plaque (+0.26 segments per +5 kg/m2, 95% CI: 0.22-0.30, P < 0.001). Larger BMI categories were associated with an increase in all-cause mortality (P = 0.004), but no difference in non-fatal MI. After multivariable adjustment, a higher BMI was independently associated with increased risk of MI (hazards ratio: 1.28 per +5 kg/m2, 95% CI: 1.12-1.45, P < 0.001).ConclusionsAmongst patients with suspected CAD referred for CCTA, individuals with increased BMI have greater prevalence, extent, and severity of CAD that is not fully explained by the presence of traditional risk factors. A higher BMI is independently associated with increased risk of intermediate-term risk of myocardial infarction.

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