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Clustering of Metabolic Abnormalities Among Obese Patients and Mortality After Percutaneous Coronary Intervention

Although current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of met... Full description

Journal Title: The American journal of cardiology 2011, Vol.107 (10), p.1415-1420
Main Author: Bashey, Sameer, MD
Other Authors: Muntner, Paul, PhD , Kini, Annapoorna S., MD , Esquitin, Ricardo, MD , Razzouk, Louai, MD , Mathewkutty, Shiny, MD , Wildman, Rachel P., PhD , Carson, April P., PhD , Kim, Michael C., MD , Moreno, Pedro R., MD , Sharma, Samin K., MD , Farkouh, Michael E., MD, MSc
Format: Electronic Article Electronic Article
Language: English
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Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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recordid: cdi_proquest_miscellaneous_864964782
title: Clustering of Metabolic Abnormalities Among Obese Patients and Mortality After Percutaneous Coronary Intervention
format: Article
creator:
  • Bashey, Sameer, MD
  • Muntner, Paul, PhD
  • Kini, Annapoorna S., MD
  • Esquitin, Ricardo, MD
  • Razzouk, Louai, MD
  • Mathewkutty, Shiny, MD
  • Wildman, Rachel P., PhD
  • Carson, April P., PhD
  • Kim, Michael C., MD
  • Moreno, Pedro R., MD
  • Sharma, Samin K., MD
  • Farkouh, Michael E., MD, MSc
subjects:
  • Abridged Index Medicus
  • Aged
  • Angioplasty, Balloon, Coronary
  • Biological and medical sciences
  • Blood Glucose - analysis
  • Body Mass Index
  • C-Reactive Protein - analysis
  • Cardiac patients
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Cardiovascular disease
  • Cholesterol
  • Cholesterol, HDL - blood
  • Cluster Analysis
  • Dextrose
  • Diabetes
  • Diseases of the cardiovascular system
  • Female
  • Glucose
  • Humans
  • Hypertension
  • Hypertension - complications
  • Male
  • Medical sciences
  • Metabolic diseases
  • Metabolism
  • Mortality
  • Obesity
  • Obesity - complications
  • Obesity - metabolism
  • Obesity - mortality
  • Patient outcomes
  • Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
  • Transluminal angioplasty
  • Triglycerides
  • Triglycerides - blood
ispartof: The American journal of cardiology, 2011, Vol.107 (10), p.1415-1420
description: Although current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.5 to 24.9, 25.0 to 29.9, 30.0 to 34.9, and ≥35 kg/m2 and by number of metabolic abnormalities possessed (hypertension, impaired fasting glucose/diabetes, triglycerides ≥150 mg/dl, high-density lipoprotein cholesterol < 40 mg/dl, and C-reactive protein ≥2.0 mg/L). All-cause mortality was assessed through June 30, 2007. Mean age of patients was 65.9 years and 66% were men. Prevalences of 4 or 5 metabolic abnormalities were 12%, 18%, 24%, and 31% in patients with BMI levels of 18.5 to 24.9, 25.0 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In patients with BMI of 30.0 to 34.9 kg/m2 , hazard ratios (95% confidence intervals) for mortality associated with 2, 3, and 4 to 5 metabolic abnormalities versus 0 to 1 metabolic abnormality were 1.31 (0.79 to 2.17), 1.42 (0.83 to 2.43), and 2.39 (1.24 to 4.59), respectively. Analogous hazard ratios for patients with BMI ≥35 kg/m2 were 1.94 (0.90 to 4.20), 1.44 (0.63 to 3.28), and 2.17 (0.91 to 5.18). All-cause mortality rates per 1,000 person-years were 55.5, 33.7, 28.3, and 33.8 in patients with BMI levels of 18.5 to 24.9, 25 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m2 were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleClustering of Metabolic Abnormalities Among Obese Patients and Mortality After Percutaneous Coronary Intervention
creatorBashey, Sameer, MD ; Muntner, Paul, PhD ; Kini, Annapoorna S., MD ; Esquitin, Ricardo, MD ; Razzouk, Louai, MD ; Mathewkutty, Shiny, MD ; Wildman, Rachel P., PhD ; Carson, April P., PhD ; Kim, Michael C., MD ; Moreno, Pedro R., MD ; Sharma, Samin K., MD ; Farkouh, Michael E., MD, MSc
creatorcontribBashey, Sameer, MD ; Muntner, Paul, PhD ; Kini, Annapoorna S., MD ; Esquitin, Ricardo, MD ; Razzouk, Louai, MD ; Mathewkutty, Shiny, MD ; Wildman, Rachel P., PhD ; Carson, April P., PhD ; Kim, Michael C., MD ; Moreno, Pedro R., MD ; Sharma, Samin K., MD ; Farkouh, Michael E., MD, MSc
descriptionAlthough current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.5 to 24.9, 25.0 to 29.9, 30.0 to 34.9, and ≥35 kg/m2 and by number of metabolic abnormalities possessed (hypertension, impaired fasting glucose/diabetes, triglycerides ≥150 mg/dl, high-density lipoprotein cholesterol < 40 mg/dl, and C-reactive protein ≥2.0 mg/L). All-cause mortality was assessed through June 30, 2007. Mean age of patients was 65.9 years and 66% were men. Prevalences of 4 or 5 metabolic abnormalities were 12%, 18%, 24%, and 31% in patients with BMI levels of 18.5 to 24.9, 25.0 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In patients with BMI of 30.0 to 34.9 kg/m2 , hazard ratios (95% confidence intervals) for mortality associated with 2, 3, and 4 to 5 metabolic abnormalities versus 0 to 1 metabolic abnormality were 1.31 (0.79 to 2.17), 1.42 (0.83 to 2.43), and 2.39 (1.24 to 4.59), respectively. Analogous hazard ratios for patients with BMI ≥35 kg/m2 were 1.94 (0.90 to 4.20), 1.44 (0.63 to 3.28), and 2.17 (0.91 to 5.18). All-cause mortality rates per 1,000 person-years were 55.5, 33.7, 28.3, and 33.8 in patients with BMI levels of 18.5 to 24.9, 25 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m2 were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
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languageeng
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subjectAbridged Index Medicus ; Aged ; Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Blood Glucose - analysis ; Body Mass Index ; C-Reactive Protein - analysis ; Cardiac patients ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cholesterol ; Cholesterol, HDL - blood ; Cluster Analysis ; Dextrose ; Diabetes ; Diseases of the cardiovascular system ; Female ; Glucose ; Humans ; Hypertension ; Hypertension - complications ; Male ; Medical sciences ; Metabolic diseases ; Metabolism ; Mortality ; Obesity ; Obesity - complications ; Obesity - metabolism ; Obesity - mortality ; Patient outcomes ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Transluminal angioplasty ; Triglycerides ; Triglycerides - blood
ispartofThe American journal of cardiology, 2011, Vol.107 (10), p.1415-1420
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7Carson, April P., PhD
8Kim, Michael C., MD
9Moreno, Pedro R., MD
10Sharma, Samin K., MD
11Farkouh, Michael E., MD, MSc
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0Clustering of Metabolic Abnormalities Among Obese Patients and Mortality After Percutaneous Coronary Intervention
1The American journal of cardiology
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descriptionAlthough current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.5 to 24.9, 25.0 to 29.9, 30.0 to 34.9, and ≥35 kg/m2 and by number of metabolic abnormalities possessed (hypertension, impaired fasting glucose/diabetes, triglycerides ≥150 mg/dl, high-density lipoprotein cholesterol < 40 mg/dl, and C-reactive protein ≥2.0 mg/L). All-cause mortality was assessed through June 30, 2007. Mean age of patients was 65.9 years and 66% were men. Prevalences of 4 or 5 metabolic abnormalities were 12%, 18%, 24%, and 31% in patients with BMI levels of 18.5 to 24.9, 25.0 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In patients with BMI of 30.0 to 34.9 kg/m2 , hazard ratios (95% confidence intervals) for mortality associated with 2, 3, and 4 to 5 metabolic abnormalities versus 0 to 1 metabolic abnormality were 1.31 (0.79 to 2.17), 1.42 (0.83 to 2.43), and 2.39 (1.24 to 4.59), respectively. Analogous hazard ratios for patients with BMI ≥35 kg/m2 were 1.94 (0.90 to 4.20), 1.44 (0.63 to 3.28), and 2.17 (0.91 to 5.18). All-cause mortality rates per 1,000 person-years were 55.5, 33.7, 28.3, and 33.8 in patients with BMI levels of 18.5 to 24.9, 25 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m2 were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
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12Cholesterol
13Cholesterol, HDL - blood
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15Dextrose
16Diabetes
17Diseases of the cardiovascular system
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19Glucose
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21Hypertension
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27Mortality
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31Obesity - mortality
32Patient outcomes
33Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
34Transluminal angioplasty
35Triglycerides
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titleClustering of Metabolic Abnormalities Among Obese Patients and Mortality After Percutaneous Coronary Intervention
authorBashey, Sameer, MD ; Muntner, Paul, PhD ; Kini, Annapoorna S., MD ; Esquitin, Ricardo, MD ; Razzouk, Louai, MD ; Mathewkutty, Shiny, MD ; Wildman, Rachel P., PhD ; Carson, April P., PhD ; Kim, Michael C., MD ; Moreno, Pedro R., MD ; Sharma, Samin K., MD ; Farkouh, Michael E., MD, MSc
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17Diseases of the cardiovascular system
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abstractAlthough current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.5 to 24.9, 25.0 to 29.9, 30.0 to 34.9, and ≥35 kg/m2 and by number of metabolic abnormalities possessed (hypertension, impaired fasting glucose/diabetes, triglycerides ≥150 mg/dl, high-density lipoprotein cholesterol < 40 mg/dl, and C-reactive protein ≥2.0 mg/L). All-cause mortality was assessed through June 30, 2007. Mean age of patients was 65.9 years and 66% were men. Prevalences of 4 or 5 metabolic abnormalities were 12%, 18%, 24%, and 31% in patients with BMI levels of 18.5 to 24.9, 25.0 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In patients with BMI of 30.0 to 34.9 kg/m2 , hazard ratios (95% confidence intervals) for mortality associated with 2, 3, and 4 to 5 metabolic abnormalities versus 0 to 1 metabolic abnormality were 1.31 (0.79 to 2.17), 1.42 (0.83 to 2.43), and 2.39 (1.24 to 4.59), respectively. Analogous hazard ratios for patients with BMI ≥35 kg/m2 were 1.94 (0.90 to 4.20), 1.44 (0.63 to 3.28), and 2.17 (0.91 to 5.18). All-cause mortality rates per 1,000 person-years were 55.5, 33.7, 28.3, and 33.8 in patients with BMI levels of 18.5 to 24.9, 25 to 29.9, 30 to 34.9, and ≥35 kg/m2 , respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m2 were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
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pubElsevier Inc
pmid21420054
doi10.1016/j.amjcard.2011.01.012