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


OBJECTIVE
To recognize, among several anthropometric indexes of obesity, which one best discriminates MACE (Major Adverse Cardiac Events) after PCI.


METHODS
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.


RESULTS
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<0.0001).


CONCLUSIONS
Waist circumference was an independent predictor of MACE in men. Body Mass Index was not related to MACE and was the least frequent anthropometric index in the MACE group.
Hospital Universitário Evangélico de Curitiba, Curitiba, PR - Brasil. jestival@cardiol.br
José Carlos Estival
JC
Tarastchuk
Enio Eduardo
EE
Guérios
Ronaldo da Rocha Loures
Rda R
Bueno
Paulo Maurício Piá de
PM
Andrade
Deborah Christina
DC
Nercolini
João Gustavo Gongora
JG
Ferraz
Eduardo
E
Doubrawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D003327:Coronary Disease / Q000628:therapy*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000145:classification / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D017678:Sex Distribution; D055105:Waist Circumference; D049629:Waist-Hip Ratio
D015415:Biomarkers