Relation of Waist-Hip Ratio to Long-Term Cardiovascular Events in Patients with Coronary Artery Disease

Citation

Medina-Inojosa, Jose R.; Batsis, John A.; Supervia, Marta; Somers, Virend K.; Thomas, Randal J.; Jenkins, Sarah; Grimes, Chassidy; & Lopez-Jimenez, Francisco (2018). Relation of Waist-Hip Ratio to Long-Term Cardiovascular Events in Patients with Coronary Artery Disease. American Journal of Cardiology, 121(8), 903-909. PMCID: PMC6053270

Abstract

We aimed to assess the association between measures of obesity and outcomes in coronary artery disease (CAD) patients. We included consecutive patients referred to cardiac rehabilitation for previous CAD events, who were classified using body mass index (BMI) groups and gender-specific tertiles of waist-to-hip ratio (WHR). Follow-up was ascertained using a population-based, record linkage system. Major cardiovascular event (MACE) was defined as the composite outcome including acute coronary syndromes, coronary revascularization, ventricular arrhythmias, stroke, or death from any cause. We used Cox proportional hazards models adjusted for potential confounders. The cohort included 1,529 patients (74% men), 63.1 ± 12.5 years (mean age ± SD), of whom 40% were obese by BMI. Eighty-eight percent of men and 57% of women were classified as having central obesity by WHR. Median follow-up was 5.7 years and 415 patients had MACE. After adjustment, a high WHR tertile was a significant predictor for MACE in women (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.16, 2.94, p = 0.01) but not in men (HR 0.92, 95% CI 0.69, 1.22, p = 0.54). This relation in women persisted after further adjustment for BMI (HR 1.75, 95% CI 1.07, 2.87, p = 0.03). Obesity by BMI was not associated with MACE in either men (HR 1.07, 95% CI 0.76, 1.51, p = 0.69) or women (HR 0.98, 95% CI 0.62, 1.56, p = 0.95). In conclusion, WHR is associated with a higher risk of MACE among women with CAD but not in men. There was no obesity paradox when assessing obesity by BMI in patients with CAD when including nonfatal events.

URL

https://doi.org/10.1016/j.amjcard.2017.12.038

Reference Type

Journal Article

Year Published

2018

Journal Title

American Journal of Cardiology

Author(s)

Medina-Inojosa, Jose R.
Batsis, John A.
Supervia, Marta
Somers, Virend K.
Thomas, Randal J.
Jenkins, Sarah
Grimes, Chassidy
Lopez-Jimenez, Francisco

Article Type

Regular

PMCID

PMC6053270

Continent/Country

United States of America

State

Nonspecific

ORCiD

Batsis - 0000-0002-0845-4416