title: Obesity, metabolic syndrome and cardiovascular prognosis: from the Partners coronary computed tomography angiography registry.
abstract: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA).
  
  
  
  Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores. Extensive CAD was defined as SIS > 4. Association of BMI with cardiovascular prognosis was evaluated using multivariable fractional polynomial models.
  
  
  
  Mean age of the cohort was 57 ± 13 years with median follow-up of 3.2 years. Increasing BMI was associated with MetS (OR 1.28 per 1 kg/m2, p < 0.001) and burden of CAD on a univariable basis, but not after multivariable adjustment. Prognosis demonstrated a J-shaped relationship with BMI. For BMI from 20-39.9 kg/m2, after adjustment for age, gender, and smoking, MetS (HR 2.23, p = 0.009) was more strongly associated with adverse events.
  
  
  
  Compared to normal BMI, there was an increased burden of CAD for BMI > 25 kg/m2. Within each BMI category, metabolically unhealthy patients had greater extent of CAD, as measured by CCTA, compared to metabolically healthy patients.
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Cardiology Service, Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Hulten
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcio Sommer
authors.initials: MS
authors.lastname: Bittencourt
authors.affiliation: Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Preston
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Avinainder
authors.initials: A
authors.lastname: Singh
authors.affiliation: Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Carla
authors.initials: C
authors.lastname: Romagnolli
authors.affiliation: Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Ghoshhajra
authors.affiliation: Cardiology Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Shah
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Siddique
authors.initials: S
authors.lastname: Abbasi
authors.affiliation: Cardiothoracic Imaging Division, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9316, USA.
authors.forename: Suhny
authors.initials: S
authors.lastname: Abbara
authors.affiliation: Center for Wellness and Prevention Research, Baptist Health South Florida, Miami, FL, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Blaha
authors.affiliation: Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: Di Carli
authors.affiliation: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rblankstein@partners.org.|Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. rblankstein@partners.org.
authors.forename: Ron
authors.initials: R
authors.lastname: Blankstein
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001900:Boston / Q000453:epidemiology; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Cohort; Coronary artery disease; Coronary computed tomography angiography; Metabolic syndrome; Obesity; Prognosis