Background:
Obesity, along with hypertension and diabetes, is a known risk factor for coronary artery disease (CAD). Recent studies have proposed that obese individuals may actually experience less adverse cardiovascular outcomes and mortality compared to non-obese individuals, a phenomenon known as the “obesity paradox”. We sought to determine if weight gain is associated with overall CAD severity measured by coronary angiography.
Methods:
Suspected CAD patients (n=418) were enrolled in the Multi-Analyte, Thrombogenic, and Genetic Markers of Atherosclerosis (MAGMA) study prior to elective cardiac catheterization. Demographics and weight information were obtained, and maximum weight gain (MWG) was defined as the percent increase in weight from year of high school graduation to year of heaviest weight. Subjects were divided into the following quartiles based on MWG: none (≤30%), minor (31%-47%), major (48%-69%), and extreme (≥70%). Detailed lipid profiling was determined by vertical density gradient ultracentrifugation, thrombin-induced platelet fibrin clot strength (TIP-FCS) by thromboelastography, and urinary 11-dehydrothromboxane B2 (11-dhTxB2) by ELISA. Severity of CAD was defined as none/minimal (<20%), moderate (20-75%), and severe (75%) luminal diameter obstruction of any major coronary vessel.
Results:
The average MWG in the study population was 53 ± 33%. Patients in the extreme MWG group had the highest incidence of DM (47.5%), hypertension (80.8%), and depression (25.3%), and were most often female (59.6%). There was an inverse relationship between MWG and CAD severity (p=0.005)(figure). TIP-FCS increased in a stepwise fashion with MWG (p=0.001). 11-dTxB2 and triglyceride levels were significantly higher in the extreme MWG group, regardless of cholesterol lowering therapy (p<0.05 for all).
Conclusion:
Our data suggest that weight gain is associated with heightened thrombotic risk but not an increased risk for CAD.
Retraction Note: Association of severity of coronary artery disease by SYNTAX score (SS) and lower extremity arterial disease by duplex ultrasound (DUS) study—an Indian perspective
