Central Obesity and Survival in Subjects With Coronary Artery Disease A Systematic Review of the Literature and Collaborative Analysis With Individual Subject Data

Title
Central Obesity and Survival in Subjects With Coronary Artery Disease A Systematic Review of the Literature and Collaborative Analysis With Individual Subject Data
Author(s)
박종선김영조이상희Thais Coutinho[Thais Coutinho]Kashish Goel[Kashish Goel]Daniel Correa de Sa[Daniel Correa de Sa]Charlotte Kragelund[Charlotte Kragelund]Alka M. Kanaya[Alka M. Kanaya]Marianne Zeller[Marianne Zeller]F. Lopez-Jimenez[F. Lopez-Jimenez]Lars Kober [Lars Kober ]C. Torp-Pedersen[C. Torp-Pedersen]Yves Cottin[Yves Cottin]Luc Lorgis[Luc Lorgis]Randal Thomas[Randal Thomas]Veronique L. Roger[Veronique L. Roger]Virend K. Somers[Virend K. Somers]
Keywords
BODY-MASS INDEX; ACUTE MYOCARDIAL-INFARCTION; TO-HIP RATIO; CARDIOVASCULAR-DISEASE; ABDOMINAL OBESITY; HEART-DISEASE; WAIST CIRCUMFERENCE; WEIGHT-LOSS; IMPACT; MORTALITY
Issue Date
201105
Publisher
ELSEVIER SCIENCE INC
Citation
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, v.57, no.19, pp.1877 - 1886
Abstract
Objectives 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. Background The question of which measure of obesity better predicts survival in patients with CAD is controversial. Methods We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6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. Results 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 We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort.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). Conclusions In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality. (J Am Coll Cardiol 2011;57:1877-86) (C) 2011 by the American College of Cardiology Foundation
URI
http://hdl.handle.net/YU.REPOSITORY/25263http://dx.doi.org/10.1016/j.jacc.2010.11.058
ISSN
0735-1097
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의과대학 > 내과학교실 > Articles
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