Related Experiment Videos
Variations in coronary procedure utilization depending on body mass index
William S Yancy1, Maren K Olsen, Lesley H Curtis
1Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, NC 27705, USA. yancy006@mc.duke.edu
Archives of Internal Medicine
|June 29, 2005
Summary
Higher body mass index (BMI) is linked to lower use of invasive heart procedures after heart attack. Patients with very high BMI were less likely to receive cardiac catheterization or bypass surgery.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Increased body mass index (BMI) is a known risk factor for coronary heart disease.
- Higher BMI is associated with reduced utilization of preventive cardiac services.
- The impact of BMI on diagnostic and therapeutic procedures for coronary heart disease remains understudied.
Purpose of the Study:
- To investigate the relationship between body mass index (BMI) and the utilization of key invasive coronary procedures.
- To examine how different BMI categories affect the likelihood of receiving cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass grafting in patients hospitalized for acute myocardial infarction.
Main Methods:
- Analysis of Medicare patient data (109,664 individuals) hospitalized for acute myocardial infarction between 1994-1996.
- Logistic regression used to assess the association between BMI and the utilization of cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass grafting.
- Adjustments made for patient and hospital characteristics to isolate the effect of BMI.
Main Results:
- Patients with BMI between 25.0 and 35.0 demonstrated the highest rates of coronary procedure utilization.
- Individuals with a BMI of 35.0 to 39.9 had lower odds of undergoing coronary artery bypass grafting (OR, 0.88).
- Patients with a BMI of 40.0 or greater exhibited significantly lower odds for cardiac catheterization (OR, 0.82) and coronary artery bypass grafting (OR, 0.68).
Conclusions:
- Very high body mass index (BMI) is associated with decreased likelihood of receiving invasive coronary procedures among patients hospitalized with acute myocardial infarction.
- Significant disparities in the utilization of cardiac procedures exist based on patient BMI.
- Further research is warranted to understand the underlying reasons for these variations in care delivery and utilization.