title: Coronary artery disease in patients with body mass index ≥30 kg/m(2): a retrospective chart analysis.
abstract: OBJECTIVE
  In this study, we evaluated obesity as a single risk factor for coronary artery disease (CAD), along with the synergistic effect of obesity and other risk factors.
  
  
  METHODS
  A retrospective study of 7,567 patients admitted to hospital for chest pain from 2005 to 2014 and underwent cardiac catheterization. Patients were divided into two groups: obese and normal with body mass index (BMI) calculated as ≥30 kg/m(2) and <25, respectively. We assessed the modifiable and non-modifiable risk factors in obese patients and the degree of CAD.
  
  
  RESULTS
  Of the 7,567 patients who underwent cardiac catheterization, 414 (5.5%) had a BMI ≥30. Of 414 obese patients, 332 (80%) had evidence of CAD. Obese patients displayed evidence of CAD at the age of 57 versus 63.3 in non-obese patients (p<0.001). Of the 332 patients with CAD and obesity, 55.4% had obstructive CAD versus 44.6% with non-obstructive CAD. In obese patients with CAD, male gender and history of smoking were major risk factors for development of obstructive CAD (p=0.001 and 0.01, respectively) while dyslipidemia was a major risk factor for non-obstructive CAD (p=0.01). Additionally, obese patients with more than one risk factor developed obstructive CAD compared to non-obstructive CAD (p=0.003).
  
  
  CONCLUSIONS
  Having a BMI ≥30 appears to be a risk factor for early development of CAD. Severity of CAD in obese patients is depicted on non-modifiable and modifiable risk factors such as the male gender and smoking or greater than one risk factor, respectively.
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA; Hassan.alkhawam@mssm.edu.
authors.forename: Hassan
authors.initials: H
authors.lastname: Alkhawam
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Nguyen
authors.affiliation: Cardiology Department, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Sayanlar
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Sogomonian
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: Ronak
authors.initials: R
authors.lastname: Desai
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: JoshPaul
authors.initials: J
authors.lastname: Jolly
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Vyas
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: Umer
authors.initials: U
authors.lastname: Syed
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: Maher
authors.initials: M
authors.lastname: Homsi
authors.affiliation: Cardiology Department, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Rubinstein
keywords: body mass index≥30; coronary artery disease; dyslipidemia; hypertension; obesity; obstructive CAD; smoking