Association of obesity indices with in-hospital and 1-year mortality following acute coronary syndrome

According to the "obesity paradox", adults with obesity have a survival advantage following acute coronary syndrome, compared with those without obesity. Previous studies focused on peripheral obesity and whether this advantage is conferred by central obesity is unknown. The objective of t...

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Vydáno v:International Journal of Obesity Ročník 45; číslo 2; s. 358 - 368
Hlavní autoři: Balayah, Zuhur, Alsheikh-Ali, Alawi A, Rashed, Wafa, Almahmeed, Wael, Mulla, Arif Al, Alrawahi, Najib, Mora, Samia, Dugani, Sagar B, Zubaid, Mohammad
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Nature Publishing Group 01.02.2021
Témata:
Acute Coronary Syndrome - complications
Acute Coronary Syndrome - mortality
Acute coronary syndromes
Body Mass Index
Cause of Death
Female
Hospital Mortality
Humans
Male
Men
Middle Aged
Middle East - epidemiology
Mortality
Mortality risk
Obesity
Obesity - classification
Obesity - complications
Obesity - mortality
Paradoxes
Patients
Prevalence
Prospective Studies
Regression analysis
Regression models
Risk
Risk Factors
Time Factors
Waist Circumference
Waist-Height Ratio
Women
Middle East
ISSN:0307-0565, 1476-5497, 1476-5497
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Shrnutí:According to the "obesity paradox", adults with obesity have a survival advantage following acute coronary syndrome, compared with those without obesity. Previous studies focused on peripheral obesity and whether this advantage is conferred by central obesity is unknown. The objective of this study was to describe the association of peripheral and central obesity indices with risk of in-hospital and 1-year mortality following acute coronary syndrome (ACS). Gulf COAST is a prospective ACS registry that enrolled 4044 patients age ≥18 years from January 2012 through January 2013, across 29 hospitals in four Middle Eastern countries. Associations of indices of peripheral obesity (body-mass index, [BMI]) and central obesity (waist circumference [WC] and waist-to-height ratio [WHtR]) with mortality following ACS were analyzed in logistic regression models (odds ratio, 95% CI) with and without adjustment for Global Registry of Acute Coronary Events risk score. Of 3882 patients analyzed (mean age: 60 years; 33.3% women [n = 1294]), the prevalence of obesity was 34.5% (BMI ≥ 30.0 kg/m ), 72.2% (WC ≥ 94.0 cm [men] or ≥80.0 cm [women]) and 90.0% (WHtR ≥ 0.5). In adjusted models, deciles of obesity indices showed higher risk of mortality at extreme versus intermediate deciles (U-shaped). When defined by conventional cut-offs, peripheral obesity (BMI ≥ 30.0 versus 18.5-29.9 kg/m ) showed inverse association with risk of in-hospital mortality (0.64; 95% CI, 0.42-0.99; P = 0.04; central obesity showed trend toward reduced mortality). In contrast, for risk of 1-year mortality, all indices showed inverse association. Obesity, defined by presence of all three indices, versus nonobesity showed inverse association with risk of 1-year mortality (0.52; 95% CI, 0.35-0.75; P = 0.001). Results were similar among men and women. The degree of obesity paradox following ACS depends on the obesity index and follow-up time. Obesity indices may aid in risk stratification of mortality following ACS.
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ISSN:0307-0565
1476-5497
1476-5497
DOI:10.1038/s41366-020-00679-0