BMI Inversely Related to Long-Term Mortality in Coronary Artery Disease

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NEW YORK (Reuters Health) Jun 29 - In a retrospective study of adults with suspected or known coronary artery disease, being underweight was an independent predictor of long-term mortality, whereas overweight and obese patients had a lower mortality risk than normal-weight individuals.

"The explanation of the underweight patients and adverse outcome might be the prevalence of chronic obstructive pulmonary disease in this population, or (still unknown) malignancies," study investigator Dr. Don Poldermans told Reuters Health.

Dr. Poldermans from Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues examined data on 5,950 CAD patients seen at the center between 1993 and 2005.

During a mean follow-up of 6 years, mortality in underweight, normal-weight, overweight and obese individuals was 39%, 35%, 24%, and 20%, respectively, the team reports in the May issue of the American Journal of Cardiology. Corresponding rates of cardiac death or MI were 33%, 26%, 17%, and 14%.

In multivariate analysis, the hazard ratio for mortality in underweight patients was 2.4 compared with normal-weight patients. Overweight and obese patients had a significantly lower mortality risk, with hazard ratios of 0.65 and 0.61, respectively.

"These data are corrected for underlying cardiac risk factors and non-invasive cardiac imaging," Dr. Poldermans noted.

The study team points out in their report that the paradoxical relation of higher BMI with lower mortality has been observed recently in other patient populations, including patients with chronic heart failure and renal disease. At the moment, the reason for this "is not understood," they say.

Am J Cardiol 2007;99:1485-1490.

Source: http://www.medscape.com/viewarticle/559125?src=mp