Obesity and coronary intervention: should we continue to use Body Mass Index as a risk factor?

Central anthropometric indexes are better than the body mass index to discriminate elevated coronary risk. However, the Body Mass Index (BMI) is still the most frequently studied anthropometric index on outcomes of patients undergoing percutaneous coronary angioplasty (PCI). To recognize, among seve...

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Published in:Arquivos brasileiros de cardiologia 2008-05, Vol.90 (5), p.284-289
Main Authors: Tarastchuk, José Carlos Estival, Guérios, Enio Eduardo, Bueno, Ronaldo da Rocha Loures, Andrade, Paulo Maurício Piá de, Nercolini, Deborah Christina, Ferraz, João Gustavo Gongora, Doubrawa, Eduardo
Format: Article
Language:eng ; por
Subjects:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary - adverse effects
Biomarkers - analysis
Body Mass Index
Coronary Disease - therapy
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Obesity - classification
Obesity - complications
Postoperative Complications - etiology
Prognosis
Sex Distribution
Waist Circumference
Waist-Hip Ratio
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Summary:Central anthropometric indexes are better than the body mass index to discriminate elevated coronary risk. However, the Body Mass Index (BMI) is still the most frequently studied anthropometric index on outcomes of patients undergoing percutaneous coronary angioplasty (PCI). To recognize, among several anthropometric indexes of obesity, which one best discriminates MACE (Major Adverse Cardiac Events) after PCI. Subjects were 308 patients (mean age 61.92+/-11.06 years, 60.7% of them men) who had undergone successful coronary angioplasties. Six months after the procedure, patients were contacted for clinical follow-up. Major Adverse Cardiac Events included death, acute myocardial infarction, cardiac surgery, reintervention, angina, or evidence of myocardial ischemia on a non-invasive test. Patients were divided into 2 groups: Group 1 (with MACE, n=91, 29.5%), Group 2 (with no MACE, n= 217; 70.45%). For men and women, the anthropometric indexes studied and their respective cut-off points were waist circumference >90/80 cm, Waist-Hip Ratio > 0.90/0.80 cm, Conicity Index > 1.25/1.18, and Body Mass Index > or =30. There were more cases of familial history and previous infarct in Group 2. For men, waist circumference >90 cm (p=0.0498) in multivariate analyses was an independent predictor of MACE. BMI was not related to MACE. In Group 1, the prevalence of an elevated BMI was significantly different compared to the other anthropometric indexes studied (p
ISSN:1678-4170