title: Relationship between body mass index and left main disease: the obesity paradox.
abstract: OBJECTIVE
  Obesity is a well-known risk factor for development of diabetes, hypertension, and coronary artery disease. However, the obesity paradox shows that short-term outcome has been reported to be superior after revascularization in overweight patients. We conducted this study to examine this theory in patients who were candidates for coronary artery bypass graft and to determine if there is a relationship between obesity and the severity of coronary artery involvement and left main disease in Iranian patients.
  
  
  METHODS
  A total of 15,550 patients who had undergone isolated coronary artery bypass graft were studied retrospectively. All medical records of the aforementioned patients were derived from our hospital surgery data bank. Preoperative angiography was used for angiographic data.
  
  
  RESULTS
  After adjusting for confounding variables, we still found a significant relationship with higher BMI and lower prevalence of left main disease.
  
  
  CONCLUSIONS
  We found that despite a higher prevalence of hypertension, diabetes mellitus, and dyslipidemia, overweight and obese patients who were candidates for coronary artery bypass graft surgery were significantly less likely to have left main disease according to preoperative angiography. This study suggests that obese patients are more likely to be referred for coronary artery bypass graft in earlier stages of coronary involvement.
authors.affiliation: Cardiovascular Surgery Department, Tehran Heart Center, Tehran University of Medical Sciences, Iran. dr.mahmoodshirzad@yahoo.com
authors.forename: Mahmood
authors.initials: M
authors.lastname: Shirzad
authors.forename: Abbasali
authors.initials: A
authors.lastname: Karimi
authors.forename: Samaneh
authors.initials: S
authors.lastname: Dowlatshahi
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Ahmadi
authors.forename: Saeed
authors.initials: S
authors.lastname: Davoodi
authors.forename: Mehrab
authors.initials: M
authors.lastname: Marzban
authors.forename: Namvar
authors.initials: N
authors.lastname: Movahedi
authors.forename: Kyomars
authors.initials: K
authors.lastname: Abbasi
authors.forename: Mahmood Sheikh
authors.initials: MS
authors.lastname: Fathollahi
mesh_terms: D000368:Aged; D015992:Body Mass Index; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome