Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data

The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. The question of which measure of obesity better predicts survival in patie...

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Veröffentlicht in:Journal of the American College of Cardiology Jg. 57; H. 19; S. 1877
Hauptverfasser: Coutinho, Thais, Goel, Kashish, Corrêa de Sá, Daniel, Kragelund, Charlotte, Kanaya, Alka M, Zeller, Marianne, Park, Jong-Seon, Kober, Lars, Torp-Pedersen, Christian, Cottin, Yves, Lorgis, Luc, Lee, Sang-Hee, Kim, Young-Jo, Thomas, Randal, Roger, Véronique L, Somers, Virend K, Lopez-Jimenez, Francisco
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 10.05.2011
Schlagworte:
Animals
Body Mass Index
Cohort Studies
Cooperative Behavior
Coronary Artery Disease - complications
Coronary Artery Disease - mortality
Follow-Up Studies
Humans
Obesity, Abdominal - complications
Obesity, Abdominal - mortality
Survival Rate - trends
ISSN:1558-3597, 1558-3597
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Abstract The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. The question of which measure of obesity better predicts survival in patients with CAD is controversial. We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months. From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI ≥30 kg/m(2) (HR: 1.93, 95% CI: 1.61 to 2.32). In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.
AbstractList The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. The question of which measure of obesity better predicts survival in patients with CAD is controversial. We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months. From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI ≥30 kg/m(2) (HR: 1.93, 95% CI: 1.61 to 2.32). In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.
The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients.OBJECTIVESThe aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients.The question of which measure of obesity better predicts survival in patients with CAD is controversial.BACKGROUNDThe question of which measure of obesity better predicts survival in patients with CAD is controversial.We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months.METHODSWe searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months.From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI ≥30 kg/m(2) (HR: 1.93, 95% CI: 1.61 to 2.32).RESULTSFrom 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI ≥30 kg/m(2) (HR: 1.93, 95% CI: 1.61 to 2.32).In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.CONCLUSIONSIn subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.
Author Somers, Virend K
Corrêa de Sá, Daniel
Thomas, Randal
Roger, Véronique L
Goel, Kashish
Cottin, Yves
Coutinho, Thais
Torp-Pedersen, Christian
Park, Jong-Seon
Kober, Lars
Lorgis, Luc
Kim, Young-Jo
Lopez-Jimenez, Francisco
Kanaya, Alka M
Lee, Sang-Hee
Zeller, Marianne
Kragelund, Charlotte
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SubjectTerms Animals
Body Mass Index
Cohort Studies
Cooperative Behavior
Coronary Artery Disease - complications
Coronary Artery Disease - mortality
Follow-Up Studies
Humans
Obesity, Abdominal - complications
Obesity, Abdominal - mortality
Survival Rate - trends
Title Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data
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