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Obesity and cardiovascular events in patients with established coronary disease

Michael J Domanski1, Kathleen A Jablonski, Madeline Murguia Rice

  • 1The Clinical Trials Group, National Heart, Lung, and Blood Institute, Bethesda, MD, USA. domanskm@nhlbi.nih.gov

European Heart Journal
|May 19, 2006
PubMed

Insights

Obesity is linked to major adverse coronary events (MACE) in men with coronary artery disease (CAD), but not in women. Further research is needed to understand this sex-specific association.

Area of Science:

  • Cardiology
  • Public Health
  • Obesity Research

Background:

  • Established coronary artery disease (CAD) affects millions globally.
  • The role of obesity as a risk factor for adverse cardiovascular events in patients with existing CAD requires clarification.
  • Previous studies have yielded conflicting results regarding obesity and cardiovascular outcomes in CAD patients.

Purpose of the Study:

  • To investigate the association between obesity and major adverse coronary events (MACE) in individuals with established CAD.
  • To determine if obesity is an independent risk factor for MACE in a large, randomized trial cohort.
  • To explore potential sex differences in the relationship between obesity and MACE.

Main Methods:

  • Post hoc analysis of the Prevention of Events with Angiotensin Converting Enzyme-Inhibition (PEACE) Trial data.
  • Inclusion of 8290 patients with stable CAD and left ventricular ejection fraction >= 0.40.
  • Obesity defined as body mass index (BMI) >= 30 kg/m(2); MACE defined as cardiovascular death, non-fatal myocardial infarction, coronary revascularization, or stroke. Analysis conducted separately for men and women.

Main Results:

  • Obesity was significantly associated with an increased risk of MACE in men (Hazard Ratio [HR] = 1.28, P < 0.01).
  • No significant association between obesity and MACE was observed in women (HR = 0.96, P = 0.77).
  • A J-shaped association between BMI and MACE was noted in men, with no such pattern in women.

Conclusions:

  • In patients with established CAD, obesity is an independent risk factor for MACE in men.
  • The association between obesity and MACE in women with established CAD was not supported by this study.
  • These findings highlight a potential sex-specific difference in cardiovascular risk associated with obesity in CAD patients, warranting further investigation.
Abstract

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