Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox
BackgroundPrognosis based on body fat percentage (BF%) in patients with coronary artery disease has not been extensively studied. We tested the hypothesis that patients with coronary artery disease and increased BF% have a higher risk for major adverse cardiovascular events (MACEs) and that fat‐free...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.007505 |
| _version_ | 1828878343131365376 |
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| author | Jose R. Medina‐Inojosa Virend K. Somers Randal J. Thomas Nathalie Jean Sarah M. Jenkins Miguel Angel Gomez‐Ibarra Marta Supervia Francisco Lopez‐Jimenez |
| author_facet | Jose R. Medina‐Inojosa Virend K. Somers Randal J. Thomas Nathalie Jean Sarah M. Jenkins Miguel Angel Gomez‐Ibarra Marta Supervia Francisco Lopez‐Jimenez |
| author_sort | Jose R. Medina‐Inojosa |
| collection | DOAJ |
| description | BackgroundPrognosis based on body fat percentage (BF%) in patients with coronary artery disease has not been extensively studied. We tested the hypothesis that patients with coronary artery disease and increased BF% have a higher risk for major adverse cardiovascular events (MACEs) and that fat‐free mass is associated with better prognosis. Methods and ResultsWe included 717 patients referred to cardiac rehabilitation after coronary artery disease events or procedures who underwent air displacement plethysmography to assess BF%; 75% were men, with a mean age 61.4±11.4 years and a mean body mass index of 30±5.4 kg/m2. Follow‐up was performed using a record linkage system. Patients were classified in sex‐specific quartiles of BF% and fat‐free mass index. The composite outcome of MACEs included acute coronary syndromes, coronary revascularization, stroke, or death from any cause. After a median follow‐up of 3.9 years, 201 patients had a MACE. After adjusting for covariates, body mass index was not associated with MACEs (P=0.12). However, the risk of MACEs for those in the highest BF% quartile was nearly double when compared with those in the lowest quartile (hazard ratio, 1.89; 95% confidence interval, 1.30–2.77; P=0.0008). In contrast, fat‐free mass was inversely associated with MACEs. The risk of MACEs for those in the fourth fat‐free mass quartile was lower (adjusted hazard ratio, 0.53; 95% confidence interval, 0.35–0.82; P=0.004), when compared with those in the first quartile. ConclusionsIn patients with coronary artery disease, there is no obesity paradox when measuring BF% instead of body mass index. BF% is associated with a higher risk of MACEs, whereas fat‐free mass is associated with a lower risk of MACEs. Body mass index was not associated with MACEs. |
| first_indexed | 2024-12-13T09:03:43Z |
| format | Article |
| id | doaj.art-e1e6540af68e4d748f610ee3335e8a41 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:03:43Z |
| publishDate | 2018-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-e1e6540af68e4d748f610ee3335e8a412022-12-21T23:53:07ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-05-0171010.1161/JAHA.117.007505Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No ParadoxJose R. Medina‐Inojosa0Virend K. Somers1Randal J. Thomas2Nathalie Jean3Sarah M. Jenkins4Miguel Angel Gomez‐Ibarra5Marta Supervia6Francisco Lopez‐Jimenez7Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDivision of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDivision of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDivision of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDivision of Health Sciences Research, Mayo Clinic, Rochester, MNDivision of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDivision of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDivision of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNBackgroundPrognosis based on body fat percentage (BF%) in patients with coronary artery disease has not been extensively studied. We tested the hypothesis that patients with coronary artery disease and increased BF% have a higher risk for major adverse cardiovascular events (MACEs) and that fat‐free mass is associated with better prognosis. Methods and ResultsWe included 717 patients referred to cardiac rehabilitation after coronary artery disease events or procedures who underwent air displacement plethysmography to assess BF%; 75% were men, with a mean age 61.4±11.4 years and a mean body mass index of 30±5.4 kg/m2. Follow‐up was performed using a record linkage system. Patients were classified in sex‐specific quartiles of BF% and fat‐free mass index. The composite outcome of MACEs included acute coronary syndromes, coronary revascularization, stroke, or death from any cause. After a median follow‐up of 3.9 years, 201 patients had a MACE. After adjusting for covariates, body mass index was not associated with MACEs (P=0.12). However, the risk of MACEs for those in the highest BF% quartile was nearly double when compared with those in the lowest quartile (hazard ratio, 1.89; 95% confidence interval, 1.30–2.77; P=0.0008). In contrast, fat‐free mass was inversely associated with MACEs. The risk of MACEs for those in the fourth fat‐free mass quartile was lower (adjusted hazard ratio, 0.53; 95% confidence interval, 0.35–0.82; P=0.004), when compared with those in the first quartile. ConclusionsIn patients with coronary artery disease, there is no obesity paradox when measuring BF% instead of body mass index. BF% is associated with a higher risk of MACEs, whereas fat‐free mass is associated with a lower risk of MACEs. Body mass index was not associated with MACEs.https://www.ahajournals.org/doi/10.1161/JAHA.117.007505adipose tissuecardiac rehabilitationcoronary artery disease |
| spellingShingle | Jose R. Medina‐Inojosa Virend K. Somers Randal J. Thomas Nathalie Jean Sarah M. Jenkins Miguel Angel Gomez‐Ibarra Marta Supervia Francisco Lopez‐Jimenez Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease adipose tissue cardiac rehabilitation coronary artery disease |
| title | Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox |
| title_full | Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox |
| title_fullStr | Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox |
| title_full_unstemmed | Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox |
| title_short | Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox |
| title_sort | association between adiposity and lean mass with long term cardiovascular events in patients with coronary artery disease no paradox |
| topic | adipose tissue cardiac rehabilitation coronary artery disease |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.007505 |
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