Relation between body mass index, waist circumference, and death after acute myocardial infarction
An elevated body mass index (BMI) has been reported to be associated with a lower rate of death after acute myocardial infarction (AMI). However, waist circumference (WC) may be a better marker of cardiovascular risk than BMI. We used data from a contemporary French population-based cohort of patien...
Uloženo v:
| Vydáno v: | Circulation (New York, N.Y.) Ročník 118; číslo 5; s. 482 |
|---|---|
| Hlavní autoři: | , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
29.07.2008
|
| Témata: | |
| ISSN: | 1524-4539, 1524-4539 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | An elevated body mass index (BMI) has been reported to be associated with a lower rate of death after acute myocardial infarction (AMI). However, waist circumference (WC) may be a better marker of cardiovascular risk than BMI. We used data from a contemporary French population-based cohort of patients with AMI to analyze the impact of WC and BMI on death rates.
We evaluated 2229 consecutive patients with AMI. Patients were classified according to BMI as normal, overweight, obese, and very obese (BMI <25, 25 to 29.9, 30 to 34.5, and >35 kg/m(2), respectively) and as increased waistline (WC >88/102 cm for women/men) or normal. Half of the patients were overweight (n=1044), and one quarter were obese (n=397) or very obese (n=128). Increased WC was present in half of the patients (n=1110). Increased BMI was associated with a reduced death rate, with a 5% risk reduction for each unit increase in BMI (hazard ratio, 0.95; 95% CI, 0.93 to 0.98; P<0.001). In contrast, WC as a continuous variable had no impact on all-cause death (P=0.20). After adjustment for baseline predictors of death, BMI was not independently predictive of death. The group of patients with high WC but low BMI had increased 1-year death rate.
Neither BMI nor WC independently predicts death after AMI. Much of the inverse relationship between BMI and the rate of death after AMI is due to confounding by characteristics associated with survival. This study emphasizes the need to measure both BMI and WC because patients with a high WC and low BMI are at high risk of death. |
|---|---|
| AbstractList | An elevated body mass index (BMI) has been reported to be associated with a lower rate of death after acute myocardial infarction (AMI). However, waist circumference (WC) may be a better marker of cardiovascular risk than BMI. We used data from a contemporary French population-based cohort of patients with AMI to analyze the impact of WC and BMI on death rates.
We evaluated 2229 consecutive patients with AMI. Patients were classified according to BMI as normal, overweight, obese, and very obese (BMI <25, 25 to 29.9, 30 to 34.5, and >35 kg/m(2), respectively) and as increased waistline (WC >88/102 cm for women/men) or normal. Half of the patients were overweight (n=1044), and one quarter were obese (n=397) or very obese (n=128). Increased WC was present in half of the patients (n=1110). Increased BMI was associated with a reduced death rate, with a 5% risk reduction for each unit increase in BMI (hazard ratio, 0.95; 95% CI, 0.93 to 0.98; P<0.001). In contrast, WC as a continuous variable had no impact on all-cause death (P=0.20). After adjustment for baseline predictors of death, BMI was not independently predictive of death. The group of patients with high WC but low BMI had increased 1-year death rate.
Neither BMI nor WC independently predicts death after AMI. Much of the inverse relationship between BMI and the rate of death after AMI is due to confounding by characteristics associated with survival. This study emphasizes the need to measure both BMI and WC because patients with a high WC and low BMI are at high risk of death. An elevated body mass index (BMI) has been reported to be associated with a lower rate of death after acute myocardial infarction (AMI). However, waist circumference (WC) may be a better marker of cardiovascular risk than BMI. We used data from a contemporary French population-based cohort of patients with AMI to analyze the impact of WC and BMI on death rates.BACKGROUNDAn elevated body mass index (BMI) has been reported to be associated with a lower rate of death after acute myocardial infarction (AMI). However, waist circumference (WC) may be a better marker of cardiovascular risk than BMI. We used data from a contemporary French population-based cohort of patients with AMI to analyze the impact of WC and BMI on death rates.We evaluated 2229 consecutive patients with AMI. Patients were classified according to BMI as normal, overweight, obese, and very obese (BMI <25, 25 to 29.9, 30 to 34.5, and >35 kg/m(2), respectively) and as increased waistline (WC >88/102 cm for women/men) or normal. Half of the patients were overweight (n=1044), and one quarter were obese (n=397) or very obese (n=128). Increased WC was present in half of the patients (n=1110). Increased BMI was associated with a reduced death rate, with a 5% risk reduction for each unit increase in BMI (hazard ratio, 0.95; 95% CI, 0.93 to 0.98; P<0.001). In contrast, WC as a continuous variable had no impact on all-cause death (P=0.20). After adjustment for baseline predictors of death, BMI was not independently predictive of death. The group of patients with high WC but low BMI had increased 1-year death rate.METHODS AND RESULTSWe evaluated 2229 consecutive patients with AMI. Patients were classified according to BMI as normal, overweight, obese, and very obese (BMI <25, 25 to 29.9, 30 to 34.5, and >35 kg/m(2), respectively) and as increased waistline (WC >88/102 cm for women/men) or normal. Half of the patients were overweight (n=1044), and one quarter were obese (n=397) or very obese (n=128). Increased WC was present in half of the patients (n=1110). Increased BMI was associated with a reduced death rate, with a 5% risk reduction for each unit increase in BMI (hazard ratio, 0.95; 95% CI, 0.93 to 0.98; P<0.001). In contrast, WC as a continuous variable had no impact on all-cause death (P=0.20). After adjustment for baseline predictors of death, BMI was not independently predictive of death. The group of patients with high WC but low BMI had increased 1-year death rate.Neither BMI nor WC independently predicts death after AMI. Much of the inverse relationship between BMI and the rate of death after AMI is due to confounding by characteristics associated with survival. This study emphasizes the need to measure both BMI and WC because patients with a high WC and low BMI are at high risk of death.CONCLUSIONSNeither BMI nor WC independently predicts death after AMI. Much of the inverse relationship between BMI and the rate of death after AMI is due to confounding by characteristics associated with survival. This study emphasizes the need to measure both BMI and WC because patients with a high WC and low BMI are at high risk of death. |
| Author | Steg, Philippe Gabriel Janin-Manificat, Luc Lorgis, Luc Lagrost, Anne-Cécile Rochette, Luc Ravisy, Jack Sicard, Pierre Makki, Hamid Beer, Jean-Claude Zeller, Marianne Cottin, Yves Laurent, Yves |
| Author_xml | – sequence: 1 givenname: Marianne surname: Zeller fullname: Zeller, Marianne email: marianne.zeller@u-bourgogne.fr organization: Laboratory of Experimental and Cardiovascular Physiopathology and Pharmacology, IFR santé-STIC, Faculty of Medicine, 7 Bd Jeanne d'Arc, 21000 Dijon, France. marianne.zeller@u-bourgogne.fr – sequence: 2 givenname: Philippe Gabriel surname: Steg fullname: Steg, Philippe Gabriel – sequence: 3 givenname: Jack surname: Ravisy fullname: Ravisy, Jack – sequence: 4 givenname: Luc surname: Lorgis fullname: Lorgis, Luc – sequence: 5 givenname: Yves surname: Laurent fullname: Laurent, Yves – sequence: 6 givenname: Pierre surname: Sicard fullname: Sicard, Pierre – sequence: 7 givenname: Luc surname: Janin-Manificat fullname: Janin-Manificat, Luc – sequence: 8 givenname: Jean-Claude surname: Beer fullname: Beer, Jean-Claude – sequence: 9 givenname: Hamid surname: Makki fullname: Makki, Hamid – sequence: 10 givenname: Anne-Cécile surname: Lagrost fullname: Lagrost, Anne-Cécile – sequence: 11 givenname: Luc surname: Rochette fullname: Rochette, Luc – sequence: 12 givenname: Yves surname: Cottin fullname: Cottin, Yves |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18625893$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkMtOwzAURC1URB_wC8hsWDXFjh0nWVYR0EoVlap2Hd3YNyIoj2I7Kv17gigSq5nFmbOYKRm1XYuEPHC24Fzxp2y9yw6b5X69fVuulgvO4kUcCZmIKzLhUSgDGYl09K-PydS5D8aYEnF0Q8Y8UWGUpGJCih3W4KuupQX6E-KQnTnTBpyjVWvwa05PUDlPdWV135RosdU4p9AaahD8O4XSo6Wge4-0OXcarKmgHsYlWP1jviXXJdQO7y45I4eX5322Cjbb13W23AQ6YsIHKAxXEAs0RQmSFxJEAaniJjQmNQwlxhApA8oYztIUtJJhrHmZKilCiTyckcdf79F2nz06nzeV01jX0GLXu1ylQg0nJQN4fwH7okGTH23VgD3nf6-E3yx8aoE |
| CitedBy_id | crossref_primary_10_1097_MD_0000000000035924 crossref_primary_10_1007_s11684_019_0729_1 crossref_primary_10_1016_j_amjcard_2023_09_024 crossref_primary_10_1016_j_ijcard_2009_12_029 crossref_primary_10_1038_s41598_022_17961_y crossref_primary_10_1016_j_numecd_2025_104104 crossref_primary_10_1111_obr_13107 crossref_primary_10_1136_heartjnl_2011_300231 crossref_primary_10_1371_journal_pone_0077082 crossref_primary_10_1016_j_atherosclerosis_2010_09_018 crossref_primary_10_1016_j_repc_2012_12_019 crossref_primary_10_1159_000537744 crossref_primary_10_1177_1741826710394305 crossref_primary_10_1155_2014_634717 crossref_primary_10_1007_s00280_016_2995_9 crossref_primary_10_1016_j_jacl_2019_06_005 crossref_primary_10_1016_j_jacl_2022_07_006 crossref_primary_10_3390_jcm11092581 crossref_primary_10_1161_JAHA_117_007505 crossref_primary_10_1038_s41598_018_35073_4 crossref_primary_10_1161_CIRCOUTCOMES_109_912501 crossref_primary_10_36660_ijcs_20200334 crossref_primary_10_3390_jcm9010116 crossref_primary_10_1136_hrt_2010_213041 crossref_primary_10_3389_fcvm_2024_1419001 crossref_primary_10_1016_j_amjcard_2010_06_009 crossref_primary_10_1007_s10654_014_9961_9 crossref_primary_10_1161_CIRCULATIONAHA_111_067264 crossref_primary_10_1177_03000605211011976 crossref_primary_10_1016_j_nut_2012_04_020 crossref_primary_10_1111_acem_12211 crossref_primary_10_2217_fca_13_84 crossref_primary_10_1097_MCA_0000000000000369 crossref_primary_10_1111_j_1532_5415_2009_02672_x crossref_primary_10_1038_nrcardio_2010_209 crossref_primary_10_1016_j_jacc_2010_11_058 crossref_primary_10_3390_ijms19010049 crossref_primary_10_4330_wjc_v12_i1_44 crossref_primary_10_1016_j_amjcard_2009_07_008 crossref_primary_10_1016_j_ejim_2021_02_001 crossref_primary_10_1136_hrt_2009_171520 crossref_primary_10_1016_j_numecd_2023_09_021 crossref_primary_10_1016_j_ijcard_2012_09_061 crossref_primary_10_1038_s41366_020_00679_0 crossref_primary_10_1371_journal_pone_0096076 crossref_primary_10_3390_ijerph182211975 crossref_primary_10_1016_j_repce_2012_12_003 crossref_primary_10_7759_cureus_24859 crossref_primary_10_1186_s12872_020_01626_7 crossref_primary_10_1016_j_mayocp_2015_12_007 crossref_primary_10_1016_j_ijcard_2013_11_043 crossref_primary_10_1016_j_jcjd_2018_09_007 crossref_primary_10_1186_s12944_021_01460_6 crossref_primary_10_1186_s40608_017_0155_3 crossref_primary_10_1016_j_hrtlng_2022_11_007 crossref_primary_10_1007_s10554_011_9882_6 crossref_primary_10_1016_j_numecd_2011_09_002 crossref_primary_10_1016_j_bbagen_2014_05_017 crossref_primary_10_1016_j_ihj_2015_09_019 crossref_primary_10_1155_2018_3407306 crossref_primary_10_3390_jcm12052068 crossref_primary_10_1016_j_physbeh_2021_113324 crossref_primary_10_1016_j_jdiacomp_2016_05_010 crossref_primary_10_1186_s12916_014_0242_y crossref_primary_10_1016_j_cvdpc_2010_08_002 crossref_primary_10_1155_2012_124693 crossref_primary_10_1007_s10741_013_9406_7 crossref_primary_10_1016_j_amjcard_2017_07_040 crossref_primary_10_1016_j_atherosclerosis_2009_02_036 crossref_primary_10_1089_met_2008_0101 crossref_primary_10_1186_1471_2458_11_473 crossref_primary_10_3390_jcm11092423 crossref_primary_10_1016_j_acvd_2010_10_002 crossref_primary_10_1016_j_amjcard_2015_06_007 crossref_primary_10_3390_jcm8060827 crossref_primary_10_1016_j_ahj_2015_10_024 crossref_primary_10_1002_ehf2_12120 crossref_primary_10_1038_ijo_2009_244 crossref_primary_10_1089_met_2011_0099 crossref_primary_10_1200_JCO_2016_67_4846 crossref_primary_10_1016_j_ehj_2014_02_002 crossref_primary_10_1016_j_jjcc_2010_04_002 crossref_primary_10_1136_bmjdrc_2016_000200 crossref_primary_10_1016_j_ypmed_2024_108026 crossref_primary_10_1017_S002966511500169X crossref_primary_10_1177_0003319709355801 crossref_primary_10_1371_journal_pone_0208817 crossref_primary_10_1016_j_amjmed_2017_09_027 crossref_primary_10_1016_j_jacc_2012_10_035 crossref_primary_10_1016_j_mayocp_2014_04_020 crossref_primary_10_6000_1929_6029_2025_14_33 crossref_primary_10_1038_ijo_2015_176 crossref_primary_10_1161_JAHA_119_013030 crossref_primary_10_1016_j_amjcard_2009_02_026 crossref_primary_10_1177_0003319713497087 crossref_primary_10_3390_life13061365 crossref_primary_10_1007_s00592_011_0338_1 crossref_primary_10_5144_0256_4947_2014_38 crossref_primary_10_1038_s41598_023_41370_4 crossref_primary_10_3390_ijms21238985 crossref_primary_10_1016_j_biochi_2011_09_023 crossref_primary_10_1007_s10741_025_10540_z crossref_primary_10_1016_j_ahj_2023_09_001 |
| ContentType | Journal Article |
| CorporateAuthor | RICO Survey Working Group |
| CorporateAuthor_xml | – name: RICO Survey Working Group |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1161/CIRCULATIONAHA.107.753483 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine Anatomy & Physiology |
| EISSN | 1524-4539 |
| ExternalDocumentID | 18625893 |
| Genre | Research Support, Non-U.S. Gov't Journal Article |
| GroupedDBID | --- .-D .3C .55 .XZ .Z2 01R 0R~ 0ZK 18M 1J1 29B 2FS 2WC 354 40H 4Q1 4Q2 4Q3 53G 5GY 5RE 5VS 6PF 71W 77Y 7O~ AAAAV AAAXR AAEJM AAGIX AAHPQ AAIQE AAJCS AAMOA AAMTA AARTV AASOK AAUEB AAWTL AAXQO AAYOK ABBUW ABDIG ABJNI ABOCM ABPMR ABQRW ABXVJ ABZAD ACCJW ACDDN ACDOF ACEWG ACGFO ACGFS ACIJW ACILI ACOAL ACRKK ACRZS ACWDW ACWRI ACXNZ ACZKN ADBBV ADCYY ADGGA ADHPY ADNKB AE3 AE6 AEETU AENEX AFCHL AFDTB AFEXH AFFNX AFNMH AFUWQ AGINI AHMBA AHOMT AHQNM AHRYX AHVBC AIJEX AINUH AJCLO AJIOK AJJEV AJNWD AJNYG AJZMW ALKUP ALMA_UNASSIGNED_HOLDINGS AMJPA AMNEI ASPBG AVWKF AYCSE AZFZN BAWUL BOYCO BQLVK BYPQX C1A C45 CGR CS3 CUY CVF DIK DIWNM DU5 DUNZO E.X E3Z EBS ECM EIF EX3 F2K F2L F2M F2N F5P FCALG FL- FW0 GX1 H0~ H13 HZ~ H~9 IKREB IKYAY IN~ J5H JF9 JG8 JK3 JK8 K-A K-F K8S KD2 KMI KQ8 L-C L7B M18 N9A NEJ NPM N~7 N~B O9- OAG OAH OBH OCB OCUKA ODMTH OGEVE OHH OHYEH OK1 OL1 OLB OLG OLH OLU OLV OLY OLZ OPUJH ORVUJ OUVQU OVD OVDNE OVIDH OVLEI OVOZU OWBYB OWU OWV OWW OWX OWY OWZ OXXIT P2P PQQKQ RAH RLZ S4R S4S T8P TEORI TR2 UPT V2I VVN W2D W3M W8F WH7 WOQ WOW X3V X3W X7M XXN XYM YFH YOC YSK YYM YZZ ZFV ZY1 ZZMQN ~H1 7X8 AAFWJ ABPXF ABUFD ACBKD ADKSD |
| ID | FETCH-LOGICAL-c503t-e3d16a73edbfa41b4a3ba961d2dd9d0e4e7a56da6dd1099ac6427c1f964324e12 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 125 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000257994500005&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1524-4539 |
| IngestDate | Sun Nov 09 09:32:27 EST 2025 Thu Apr 03 07:02:55 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 5 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c503t-e3d16a73edbfa41b4a3ba961d2dd9d0e4e7a56da6dd1099ac6427c1f964324e12 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| OpenAccessLink | https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.107.753483 |
| PMID | 18625893 |
| PQID | 69363488 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_69363488 pubmed_primary_18625893 |
| PublicationCentury | 2000 |
| PublicationDate | 2008-07-29 |
| PublicationDateYYYYMMDD | 2008-07-29 |
| PublicationDate_xml | – month: 07 year: 2008 text: 2008-07-29 day: 29 |
| PublicationDecade | 2000 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Circulation (New York, N.Y.) |
| PublicationTitleAlternate | Circulation |
| PublicationYear | 2008 |
| References | 18663098 - Circulation. 2008 Jul 29;118(5):469-71 |
| References_xml | – reference: 18663098 - Circulation. 2008 Jul 29;118(5):469-71 |
| SSID | ssj0006375 |
| Score | 2.3262782 |
| Snippet | An elevated body mass index (BMI) has been reported to be associated with a lower rate of death after acute myocardial infarction (AMI). However, waist... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 482 |
| SubjectTerms | Aged Aged, 80 and over Body Mass Index Cohort Studies Female Follow-Up Studies Humans Kaplan-Meier Estimate Male Middle Aged Myocardial Infarction - mortality Obesity - mortality Predictive Value of Tests Risk Factors Waist-Hip Ratio |
| Title | Relation between body mass index, waist circumference, and death after acute myocardial infarction |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/18625893 https://www.proquest.com/docview/69363488 |
| Volume | 118 |
| WOSCitedRecordID | wos000257994500005&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3faxQxEB5qK6UvVVut9WcE8amxm0022YAgx2Gp0B5FrNzbkWSyUOjt9cedcv-9k-wuPokPvuxbliX7ZeabzMw3AO8bW4bCoefoioKrWDtee4w8CCLbUqArc5frjzMzmdTTqb3YgE9DL0wqqxxsYjbUuAjpjvxYW6kloe3zzS1PM6NSbrUfoPEAtiQRmYRpM_2jFa5lltklB6W4qqTdhnfZRGhxPP76bXx51snNno4ogjUfibarpB34N56Z_c3Jo__70sew2_NMNuqA8QQ2YrsH-6OWYuz5mn1gufIzX6nvwfZ5n2DfBz8Ux7G-gIv5Ba7ZnCg2y8KKR-yXI2SwcHUXVvO-WfCIuRYZJjbJ8tBx5sJqGdl8TZ4yIfCaFjd0pNKbn8LlyZfv41Pej2HgoSrkkkeJQjsjI_rGKeGVk95ZLbBEtFhEFY2rNDqNmNJsLlBIY4JoktJXqaIon8Fmu2jjc2C0L1VDhKHRUqgY6xqFMWhN8AZ9ZcMhvB22dEYwT7kL18bF6n42bOohHHR_ZXbTqXHMBMVkFbGuF_9c-xJ2umoPw0v7CrYaOuDxNTwMP5dX93dvMnroObk4_w0xrtCF |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Relation+between+body+mass+index%2C+waist+circumference%2C+and+death+after+acute+myocardial+infarction&rft.jtitle=Circulation+%28New+York%2C+N.Y.%29&rft.au=Zeller%2C+Marianne&rft.au=Steg%2C+Philippe+Gabriel&rft.au=Ravisy%2C+Jack&rft.au=Lorgis%2C+Luc&rft.date=2008-07-29&rft.eissn=1524-4539&rft.volume=118&rft.issue=5&rft.spage=482&rft_id=info:doi/10.1161%2FCIRCULATIONAHA.107.753483&rft_id=info%3Apmid%2F18625893&rft_id=info%3Apmid%2F18625893&rft.externalDocID=18625893 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1524-4539&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1524-4539&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1524-4539&client=summon |