Mean BMI, visit-to-visit BMI variability and BMI changes during follow-up in patients with acute myocardial infarction with systolic dysfunction and/or ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-05

AUTHORS

Susan Stienen, João Pedro Ferreira, Nicolas Girerd, Kévin Duarte, Zohra Lamiral, John J V McMurray, Bertram Pitt, Kenneth Dickstein, Faiez Zannad, Patrick Rossignol

ABSTRACT

BACKGROUND: In patients with acute myocardial infarction (MI), BMI < 18.5 kg/m2 and a decrease in BMI during follow-up have been associated with poor prognosis. For BMI ≥ 25 kg/m2, an "obesity paradox" has been suggested. Recently, high visit-to-visit BMI variability has also been associated with poor prognosis in patients with coronary artery disease. AIMS: To simultaneously evaluate several BMI measurements and study their association with cardiovascular (CV) outcomes in a large cohort of patients with acute myocardial infarction (MI) and left ventricular (LV) systolic dysfunction, heart failure (HF) or both. METHODS: The high-risk MI dataset is pooled from four trials: CAPRICORN, EPHESUS, OPTIMAAL and VALIANT. Mean BMI, change from baseline, and variability were assessed during follow-up. The primary outcome was CV death. Cox-proportional hazard models were performed to study the association between the various BMI parameters and outcomes (median follow-up = 1.8 years). RESULTS: A total of 12,719 patients were included (72% male, mean age 65 ± 11 years). Mean, change and visit-to-visit variability in BMI had a non-linear association with CV death (P < 0.001). Mean BMI < 26 kg/m2 (vs. ≥ 26-35 kg/m2) and BMI decrease during follow-up were independently associated with CV death (adjusted HR 1.32, 95% CI 1.16-1.51, P < 0.001 and adjusted HR 1.57, 95% CI 1.40-1.76, P < 0.001, respectively). Low and high BMI variability (< 2% and > 4%) were associated with increased event-rates, but lost statistical significance in sensitivity analysis including patients with ≥ 5 measurements or excluding patients with HF hospitalization, suggesting that BMI variability may be particularly associated with HF hospitalizations. CONCLUSION: Mean BMI < 26 kg/m2 and a BMI decrease during follow-up were independently associated with CV death in patients with MI and LV systolic dysfunction, HF or both. These associations likely reflect poorer patient status and causality cannot be inferred. More... »

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-019-01453-7

DOI

http://dx.doi.org/10.1007/s00392-019-01453-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113261774

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30953180


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Download the RDF metadata as:  json-ld nt turtle xml License info

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RDF/XML is a standard XML format for linked data.

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270 Team BIGS, INRIA, 54600, Villers-lès-Nancy, France.
271 Université de Lorraine, Institut Elie Cartan de Lorraine, UMR 7502, 54506, Vandoeuvre-lès-Nancy, France.
272 rdf:type schema:Organization
273 https://www.grid.ac/institutes/grid.5808.5 schema:alternateName University of Porto
274 schema:name Cardiovascular Research and Development Unit, Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portugal.
275 Université de Lorraine, INSERM, Centre d'Investigation Clinique et Plurithématique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
276 rdf:type schema:Organization
277 https://www.grid.ac/institutes/grid.8756.c schema:alternateName University of Glasgow
278 schema:name BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, UK.
279 rdf:type schema:Organization
 




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