Body mass index and outcome in patients with coronary, cerebrovascular, or peripheral artery disease: findings from the FRENA registry

Author:

Barba Raquel1,Bisbe Josep2,Pedrajas José Nicolas Alcalá3,Toril Jesús4,Monte Rafael1,Muñoz-Torrero Juan Francisco Sánchez1,Monreal Manuel5,

Affiliation:

1. Department of Internal Medicine, Hospital Infanta Cristina, Madrid

2. Department of Internal Medicine, Hospital de Sant Jaume, Olot, Girona

3. Department of Internal Medicine, Hospital Valle de los Pedroches, Pozoblanco, Córdoba

4. Department of Internal Medicine, Centro Médico y Rehabilitación, Castelldefels

5. Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona

Abstract

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. Conclusion 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.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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