scholarly journals Body mass index and cardiovascular outcomes in patients with acute coronary syndrome by diabetes status: the obesity paradox in a Korean national cohort study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Body Mass ◽  
Obesity Paradox ◽  
Class Ii ◽  
Normal Weight ◽  
Class I ◽  
Coronary Syndrome ◽  
Obese Class ◽  
Diabetes Status

Abstract Background The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). We investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes. Methods We identified 6978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2015. Baseline body mass index (BMI) was categorized as underweight (< 18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥ 30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results After adjustment for confounding variables, compared to normal-weight patients without diabetes (reference group), obese class I patients with and without diabetes had a lower risk of MACE, but only significant in patients without diabetes (with diabetes: hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.78–1.14; without diabetes: HR 0.78, 95% CI 0.62–0.97). Obese class II patient with diabetes had a higher risk of MACE with no statistical significance (HR 1.14, 95% CI 0.82–1.59). Underweight patients with and without diabetes had a higher risk of MACE, but only significant in patients with diabetes (with diabetes: HR 1.79, 95% CI 1.24–2.58; without diabetes: HR 1.23, 95% CI 0.77–1.97). Conclusion In ACS patients, obesity had a protective effect on CV outcomes, especially in patients without diabetes.

scholarly journals Body mass index and cardiovascular outcomes in patients with acute coronary syndrome by diabetes status: the obesity paradox in a Korean national cohort study

2020 ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Body Mass ◽  
Obesity Paradox ◽  
Class Ii ◽  
Normal Weight ◽  
Class I ◽  
Coronary Syndrome ◽  
Obese Class ◽  
Diabetes Status

Abstract Background: The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). We investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes.Methods: We identified 6,978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2015. Baseline body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results: After adjustment for confounding variables, compared to normal-weight patients without diabetes (reference group), obese class I patients with and without diabetes had a lower risk of MACE, but only significant in patients without diabetes (with diabetes: hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.78–1.14; without diabetes: HR 0.78, 95% CI 0.62–0.97). Obese class II patient with diabetes had a higher risk of MACE with no statistical significance (HR 1.14, 95% CI 0.82–1.59). Underweight patients with and without diabetes had a higher risk of MACE, but only significant in patients with diabetes (with diabetes: HR 1.79, 95% CI 1.24–2.58; without diabetes: HR 1.23, 95% CI 0.77–1.97).Conclusion: In ACS patients, obesity had a protective effect on CV outcomes, especially in patients without diabetes.

scholarly journals Body mass index and cardiovascular outcomes in patients with acute coronary syndrome by diabetic status: Korean cohort study

2020 ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Body Mass ◽  
Reference Group ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Baseline Body Mass Index ◽  
Coronary Syndrome ◽  
Obese Class ◽  
The Individual

Abstract Background: The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). Therefore, we investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes.Methods: We identified 6,978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2003 and 2015. Baseline body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results: The study included 3,989 patients with and 2,989 without diabetes. Compared to normal-weight patients without diabetes (reference group), those with diabetes had a higher risk of MACE (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.07–1.56). Obese patients without diabetes had a lower risk of MACE (HR, 0.78; 95% CI, 0.62–0.97) than those with diabetes (HR, 0.95; 95% CI 0.78–1.14). In patients without diabetes, obese BMI decreased the risk of HHF (HR, 0.62; 95% CI, 0.42–0.92) and stroke (HR, 0.61; 95% CI, 0.42–0.88), but not in those with diabetes. Conclusion: Among patients with ACS, obesity had rather protective effect on CV outcomes compared to normal weight, while this was not evident in patients with diabetes.

Impact of maternal body mass index on the cesarean delivery rate in Germany from 1990 to 2012

2015 ◽  
Vol 43 (4) ◽  
Author(s):  
Ioannis Kyvernitakis ◽  
Christine Köhler ◽  
Stephan Schmidt ◽  
Björn Misselwitz ◽  
Jasmin Großmann ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cesarean Delivery ◽  
Body Mass ◽  
Early Pregnancy ◽  
Normal Weight ◽  
Class I ◽  
Class Iii ◽  
The Past ◽  
Obese Class ◽  
Maternal Bmi

AbstractMaternal obesity is a risk factor for cesarean delivery (CD). The aim of this analysis was to determine the association between early-pregnancy body mass index (BMI) and the rate of CD over the past two decades.We retrospectively analyzed data from the perinatal quality registry of singleton deliveries in the state of Hesse in Germany from 1990 to 2012. We divided the patients into groups according to the WHO criteria for BMI: underweight (<18.5), normal weight (18.5–<25), overweight (25–<30), obese class I (30–<35), obese class II (35–<40), and obese class III (≥40).The analysis included 1,092,311 patients with available data regarding maternal BMI and mode of delivery. The CD rates for underweight (<18.5), normal weight (18.5–<25), overweight (25–<30), obese class I (30–<35), obese class II (35–<40), and obese class III (≥40) women increased from 14.4%, 16.1%, 19.5%, 22.3%, 25%, and 26.9% in the year 1990 to 27.9%, 31.4%, 38.8%, 45.1%, 50.2%, and 55.2% in the year 2012, respectively (P<0.001).Maternal BMI in early pregnancy is linearly associated with the incidence of CD. We found a disproportionate increase of CD in morbidly obese women compared with the CD incidence in the reference BMI population over the past two decades.

scholarly journals Body Mass Index and Hospital Mortality in Patients with Acute Coronary Syndrome Receiving Care in a University Hospital

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Mercedes Camprubi ◽  
Sandra Cabrera ◽  
Jordi Sans ◽  
Georgina Vidal ◽  
Teresa Salvadó ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Body Mass ◽  
Normal Weight ◽  
University Hospital ◽  
Coronary Syndrome ◽  
Established Cardiovascular Risk Factor ◽  
Obese Subjects ◽  
The Relationship

Although obesity is a well-established cardiovascular risk factor, some controversy has arisen with regard to its effect on hospital mortality in patients admitted for acute coronary syndrome.Methods. Clinical and anthropometric variables were analyzed in patients consecutively admitted for acute coronary syndrome to a university hospital between 2009 and 2010, and the correlation of those variables with hospital mortality was examined.Results. A total of 824 patients with a diagnosis of myocardial infarction or unstable angina were analyzed. Body mass index was an independent factor in hospital mortality (odds ratio 0.739 (IC 95%:0.597-0.916),P=0.006). Mortality in normal weight(n=218), overweight(n=399), and obese(n=172)subjects was 6.1%, 3.1%, and 4.1%, respectively, with no statistically significant differences between the groups.Conclusions. There is something of a paradox in the relationship between body mass index and hospital mortality in patients with acute coronary syndrome in that the mortality rate decreases as body mass index increases. However, no statistically significant differences have been found in normal weight, overweight, or obese subjects.

scholarly journals 0087 : Prognostic value of body mass index in patients with acute coronary syndrome. Is the obesity paradox real?

2016 ◽  
Vol 8 (3) ◽  
pp. 199
Author(s):  
Imad Nouamou ◽  
Kenza Benmallem ◽  
Najoua Fikal ◽  
Amina Bami ◽  
Chaimaa Houari ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Body Mass ◽  
Prognostic Value ◽  
Obesity Paradox ◽  
Coronary Syndrome

scholarly journals P25: EVALUATING THE JOINT EFFECT OF BODY MASS INDEX AND DIABETES WITH LATE-MORTALITY AFTER CORONARY ARTERY BYPASS GRAFTING

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
A Asif ◽  
T Rayner ◽  
VD Bruno ◽  
U Benedetto
Keyword(s):  
Body Mass Index ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Body Mass ◽  
Artery Bypass ◽  
Class Ii ◽  
Normal Weight ◽  
Class I ◽  
Bypass Grafting

Abstract Introduction Survival analyses following coronary artery bypass grafting (CABG) evaluate the independent effects of body mass index (BMI) and diabetes. However, BMI and diabetes are correlated and their combined effects should be considered, thus we examined the joint association on long-term survival after CABG. Method A total of 15129 patients undergoing isolated CABG between 1997 and 2017 were analysed. The BMI categories were defined as Normal-Weight (≥18-&lt;25 kg/m2;n=3783), Overweight (≥25-&lt;30 kg/m2;n=7103), Class-I-Obese (≥30-&lt;35kg/m2;n=3247), and Class-II-Obese (≥35 kg/m2;n=996). Diabetes was defined as ever having a diagnosis of diabetes (n=3203). The association was assessed using Cox-proportional hazards regression models. Result During follow-up, 3140 deaths occurred. Compared to Normal-Weight individuals, the multivariable-adjusted hazard ratios (HR) were 0.89 [95%CI: 0.82-0.96], 0.95 [95%CI: 0.86-1.10], and 1.30 [95%CI: 1.07-1.47] for Overweight, Class-I-Obese, and Class-II-Obese patients, respectively. Compared to non-diabetic patients, the multivariable-adjusted HR for diabetic patients was 1.55 [95%CI: 1.43-1.68]. In the joint analysis, compared to Normal-Weight non-diabetic individuals, the multivariable-adjusted HRs were: Normal-Weight diabetic 1.30 [95%CI: 1.10-1.53], Overweight non-diabetic 0.86 [95%CI: 0.78-0.94], Overweight diabetic 1.32 [95%CI: 1.16-1.50], Class-I-Obese non-diabetic 0.87 [95%CI: 0.77-0.99], Class-I-Obese diabetic 1.58 [95%CI: 1.53-1.85], Class-II-Obese non-diabetic 1.11 [95%CI: 0.90-1.38], and Class-II-Obese diabetic 2.06 [95%CI: 1.65-2.56]. The reduction in multivariable-adjusted 10-year survival rates for diabetics versus non-diabetics was 4%, 6%, 9%, and 14% for Normal-Weight, Overweight, Class-I-Obese, and Class-II-Obese, respectively. Conclusion A considerable difference in survival after CABG is seen in the joint analysis of diabetes and BMI and should therefore be considered in future studies. Take-home message Diabetes and body mass index (BMI) are both correlated with the incidence of coronary artery disease and the need for coronary artery bypass grafting (CABG) and are often statistically analysed as separate entities. We show that the joint affect of diabetes and BMI has a significantly higher risk of late-mortality following CABG, therefore such analyses should be considered in future studies.

Impact of Low Body Mass Index on Features of Coronary Culprit Plaques and Outcomes in Patients With Acute Coronary Syndrome

2021 ◽  
Author(s):  
Nobuaki Kobayashi ◽  
Yusaku Shibata ◽  
Osamu Kurihara ◽  
Takahiro Todoroki ◽  
Masayuki Tsutsumi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Body Mass ◽  
Coronary Syndrome ◽  
Low Body Mass Index

Abstract P72: The Obesity Paradox: Association Between Body Mass Index (BMI) and Disability After Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Brianna R Helms
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Functional Status ◽  
Hospital Discharge ◽  
Body Mass ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Stroke Recurrence ◽  
Inverse Association ◽  
Stroke Patients

Background: Present rise in the incidence of obesity has led to several opposing reports regarding the association between obesity and stroke outcomes. The objective of this study was to investigate a proposed paradoxical relationship between body mass index (BMI) and functional status in ischemic stroke patients at time of hospital discharge. Methods: Saint Francis Hospital Comprehensive Stroke Center patient databases were utilized in identifying 948 patients eligible for retrospective chart review over a period of 15 months. Subjects were divided into 4 groups according to BMI: underweight (BMI < 18.5 kg/m 2 ), normal weight (BMI 18.5-24.9 kg/m 2 ), overweight (BMI 25.0-29.9 kg/m 2 ), and obese (BMI ≥ 30.0 kg/m 2 ). Covariates, such as age, gender, prior to event modified Rankin scale (mRS), stroke recurrence, and smoking, were considered. Functional status and disability of stroke patients was scored via mRS at hospital discharge. Ordered logistic regression, Pearson’s chi-squared test, and Pearson’s r correlation were used for analysis to assess the association of BMI and functional status in ischemic strokes. Results: Of 948 eligible subjects, 49.9% were female and mean (SD) age was 69.4 (14.5) years. According to BMI, 22 (2.3%) were underweight, 247 (26.1%) normal weight, 319 (33.7%) overweight, and 360 (37.9%) obese. After adjusting for covariates, ischemic stroke patients with an increased BMI (OR, 0.98; 95% CI, 0.96-0.99) were not associated with increased disability risk upon discharge. Obese (16.2%) and overweight (14.1%) patients discharged with a mRS of 0 (back to baseline) or 1 more frequently compared to normal weight (6.1%) and underweight (0.21%) patients ( P <0.001). Furthermore, an inverse association between BMI status and disability was significantly evident ( r = -0.17, P < 0.001). Conclusion: Obese and overweight stroke patients discharge with a lower risk of disability than normal weight and underweight patients, supporting the existence of the “obesity paradox” in stroke. An inverse association between obesity status and functional outcome was identified and remained significant regardless of covariates.

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