Central obesity and survival in subjects with coronary artery disease: A systematic review of the literature and collaborative analysis with individual subject data

Thais Coutinho, Kashish Goel, Daniel Corrêa De S, Charlotte Kragelund, Alka M. Kanaya, Marianne Zeller, Jong Seon Park, Lars Kober, Christian Torp-Pedersen, Yves Cottin, Luc Lorgis, Sang Hee Lee, Young Jo Kim, Randal Thomas, Veronique Lee Roger, Virend Somers, Francisco Lopez-Jimenez

Research output: Contribution to journalArticle

200 Citations (Scopus)

Abstract

Objectives: The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. Background: The question of which measure of obesity better predicts survival in patients with CAD is controversial. Methods: We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months. Results: From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI <30 kg/m2 (HR: 1.93, 95% CI: 1.61 to 2.32). Conclusions: In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.

Original languageEnglish (US)
Pages (from-to)1877-1886
Number of pages10
JournalJournal of the American College of Cardiology
Volume57
Issue number19
DOIs
StatePublished - May 10 2011

Fingerprint

Abdominal Obesity
Coronary Artery Disease
Body Mass Index
Waist-Hip Ratio
Survival
Mortality
Waist Circumference
Confidence Intervals
Obesity

Keywords

  • central obesity
  • coronary artery disease
  • mortality
  • waist circumference
  • waist-hip ratio

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Central obesity and survival in subjects with coronary artery disease : A systematic review of the literature and collaborative analysis with individual subject data. / Coutinho, Thais; Goel, Kashish; Corrêa De S, Daniel; Kragelund, Charlotte; Kanaya, Alka M.; Zeller, Marianne; Park, Jong Seon; Kober, Lars; Torp-Pedersen, Christian; Cottin, Yves; Lorgis, Luc; Lee, Sang Hee; Kim, Young Jo; Thomas, Randal; Roger, Veronique Lee; Somers, Virend; Lopez-Jimenez, Francisco.

In: Journal of the American College of Cardiology, Vol. 57, No. 19, 10.05.2011, p. 1877-1886.

Research output: Contribution to journalArticle

Coutinho, T, Goel, K, Corrêa De S, D, Kragelund, C, Kanaya, AM, Zeller, M, Park, JS, Kober, L, Torp-Pedersen, C, Cottin, Y, Lorgis, L, Lee, SH, Kim, YJ, Thomas, R, Roger, VL, Somers, V & Lopez-Jimenez, F 2011, 'Central obesity and survival in subjects with coronary artery disease: A systematic review of the literature and collaborative analysis with individual subject data', Journal of the American College of Cardiology, vol. 57, no. 19, pp. 1877-1886. https://doi.org/10.1016/j.jacc.2010.11.058
Coutinho, Thais ; Goel, Kashish ; Corrêa De S, Daniel ; Kragelund, Charlotte ; Kanaya, Alka M. ; Zeller, Marianne ; Park, Jong Seon ; Kober, Lars ; Torp-Pedersen, Christian ; Cottin, Yves ; Lorgis, Luc ; Lee, Sang Hee ; Kim, Young Jo ; Thomas, Randal ; Roger, Veronique Lee ; Somers, Virend ; Lopez-Jimenez, Francisco. / Central obesity and survival in subjects with coronary artery disease : A systematic review of the literature and collaborative analysis with individual subject data. In: Journal of the American College of Cardiology. 2011 ; Vol. 57, No. 19. pp. 1877-1886.
@article{8e90b9a133364fd4aac37e1504de9d1a,
title = "Central obesity and survival in subjects with coronary artery disease: A systematic review of the literature and collaborative analysis with individual subject data",
abstract = "Objectives: The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. Background: The question of which measure of obesity better predicts survival in patients with CAD is controversial. Methods: We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months. Results: From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called {"}central obesity{"} was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95{\%} confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95{\%} CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95{\%} CI: 1.52 to 1.89) and BMI <30 kg/m2 (HR: 1.93, 95{\%} CI: 1.61 to 2.32). Conclusions: In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.",
keywords = "central obesity, coronary artery disease, mortality, waist circumference, waist-hip ratio",
author = "Thais Coutinho and Kashish Goel and {Corr{\^e}a De S}, Daniel and Charlotte Kragelund and Kanaya, {Alka M.} and Marianne Zeller and Park, {Jong Seon} and Lars Kober and Christian Torp-Pedersen and Yves Cottin and Luc Lorgis and Lee, {Sang Hee} and Kim, {Young Jo} and Randal Thomas and Roger, {Veronique Lee} and Virend Somers and Francisco Lopez-Jimenez",
year = "2011",
month = "5",
day = "10",
doi = "10.1016/j.jacc.2010.11.058",
language = "English (US)",
volume = "57",
pages = "1877--1886",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "19",

}

TY - JOUR

T1 - Central obesity and survival in subjects with coronary artery disease

T2 - A systematic review of the literature and collaborative analysis with individual subject data

AU - Coutinho, Thais

AU - Goel, Kashish

AU - Corrêa De S, Daniel

AU - Kragelund, Charlotte

AU - Kanaya, Alka M.

AU - Zeller, Marianne

AU - Park, Jong Seon

AU - Kober, Lars

AU - Torp-Pedersen, Christian

AU - Cottin, Yves

AU - Lorgis, Luc

AU - Lee, Sang Hee

AU - Kim, Young Jo

AU - Thomas, Randal

AU - Roger, Veronique Lee

AU - Somers, Virend

AU - Lopez-Jimenez, Francisco

PY - 2011/5/10

Y1 - 2011/5/10

N2 - Objectives: The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. Background: The question of which measure of obesity better predicts survival in patients with CAD is controversial. Methods: We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months. Results: From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI <30 kg/m2 (HR: 1.93, 95% CI: 1.61 to 2.32). Conclusions: In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.

AB - Objectives: The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients. Background: The question of which measure of obesity better predicts survival in patients with CAD is controversial. Methods: We searched OVID/Medline, EMBASE, CENTRAL, and Web of Science from 1980 to 2008 and asked experts in the field for unpublished data meeting inclusion criteria, in which all subjects had: 1) CAD at baseline; 2) measures of WC or WHR; 3) mortality data; and 4) a minimum follow-up of 6 months. Results: From 2,188 studies found, 6 met inclusion criteria. We obtained individual subject data from 4, adding unpublished data from a cardiac rehabilitation cohort. A variable called "central obesity" was created on the basis of tertiles of WHR or WC. Cox-proportional hazards were adjusted for age, sex, and confounders. The final sample consisted of 15,923 subjects. There were 5,696 deaths after a median follow-up of 2.3 (interquartile range 0.5 to 7.4) years. Central obesity was associated with mortality (hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.58 to 1.83), whereas BMI was inversely associated with mortality (HR: 0.64, 95% CI: 0.59 to 0.69). Central obesity was also associated with higher mortality in the subset of subjects with normal BMI (HR: 1.70, 95% CI: 1.52 to 1.89) and BMI <30 kg/m2 (HR: 1.93, 95% CI: 1.61 to 2.32). Conclusions: In subjects with CAD, including those with normal and high BMI, central obesity but not BMI is directly associated with mortality.

KW - central obesity

KW - coronary artery disease

KW - mortality

KW - waist circumference

KW - waist-hip ratio

UR - http://www.scopus.com/inward/record.url?scp=79955589656&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955589656&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2010.11.058

DO - 10.1016/j.jacc.2010.11.058

M3 - Article

C2 - 21545944

AN - SCOPUS:79955589656

VL - 57

SP - 1877

EP - 1886

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 19

ER -