Body mass index and outcome in patients with coronary, cerebrovascular, or peripheral artery disease: findings from the FRENA registry.
BACKGROUND
The relationship between body mass index (BMI) and mortality in patients with established arterial disease remains controversial.


METHODS
FRENA is an ongoing, observational registry of consecutive outpatients with coronary artery disease (CAD), cerebrovascular disease, or peripheral artery disease (PAD). We examined the prognostic importance of accepted BMI categories on outcome among patients in the FRENA registry.


RESULTS
In April 2008, 2274 patients (mean age, 66 years) had been enrolled, of whom 14 (0.6%) were underweight; 533 (23%) normal; 1051 (46%) overweight; and 676 (30%) were obese. Over a mean follow-up of 14 months, the incidence of major cardiovascular events (myocardial infarction, ischemic stroke, or critical limb ischemia) per 100 patient-years was: 7.1 [95% confidence interval (CI): 0.4-35]; 11 (95% CI: 8.4-14); 6.9 (95% CI: 5.6-8.5); and 8.5 (95% CI: 6.6-11), respectively. Their cardiovascular mortality was: 7.1 (95% CI: 0.4-35); 4.1 (95% CI: 5.9-11); 1.3 (95% CI: 0.9-2.3); and 1.5 (95% CI: 1.4-3.5), respectively. On multivariate analysis, the hazard ratio for cardiovascular mortality was: 2.2 (95% CI: 0.3-17); 1.0 (reference); 0.37 (95% CI: 0.20-0.69); and 0.37 (95% CI: 0.18-0.73), respectively. Survival benefit was only found in patients with CAD or PAD. Weight loss had little influence on outcome.


CONCLUSIONS
Patients with CAD or PAD (not those with cerebrovascular disease) have an inverse correlation between BMI and cardiovascular mortality, even after adjusting for confounding variables.
Department of Internal Medicine, Hospital Infanta Cristina, Madrid, Spain.
Raquel
R
Barba
Josep
J
Bisbe
José Nicolas Alcalá
JN
Pedrajas
Jesús
J
Toril
Rafael
R
Monte
Juan Francisco Sánchez
JF
Muñoz-Torrero
Manuel
M
Monreal
D000368:Aged; D015992:Body Mass Index; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000401:mortality*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013030:Spain; D015996:Survival Rate