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Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Obesity | Research article

Correlation between overweightness and the extent of coronary atherosclerosis among the South Caspian population

Authors: Maryam Nabati, Mahmood Moosazadeh, Ehsan Soroosh, Hanieh Shiraj, Mahnaneh Gholami, Ali Ghaemian

Published in: BMC Cardiovascular Disorders | Issue 1/2020

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Abstract

Background

Reported effects of obesity on the extent of angiographic coronary artery disease(CAD) have been inconsistent. The present study aimed to investigate the relationships between the indices of obesity and other anthropometric markers with the extent of CAD.

Methods

This study was conducted on 1008 consecutive patients who underwent coronary angiography. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were separately calculated for each patient. Extent, severity, and complexity of CAD were determined by the Gensini and SYNTAX scores.

Results

According to the results, there was a significant inverse correlation between the SYNTAX score with BMI (r = − 0.110; P < 0.001), WC (r = − 0.074; P = 0.018), and WHtR (r = − 0.089; P = 0.005). Furthermore, a significant inverse correlation was observed between the Gensini score with BMI (r = − 0.090; P = 0.004) and WHtR (r = − 0.065; P = 0.041). However, the results of multivariate linear regression analysis did not show any association between the SYNTAX and Gensini scores with the indices of obesity and overweight. On the other hand, the patients with an unhealthy WC had a higher prevalence of diabetes mellitus (DM) (P = 0.004) and hypertension (HTN) (P < 0.001), compared to the patients with healthy values. Coexistence of HTN and DM was more prevalent in subjects with an unhealthy WC and WHR, compared to that in those with healthy values (P = 0.002 and P = 0.032, respectively).

Conclusion

It seems that the anthropometric indices of obesity are not the predictors of the angiographic severity of CAD. However, they are associated with an increased risk of cardiovascular risk factors and higher risk profile.
Literature
1.
go back to reference Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB. Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Curr Obes Rep. 2015;4(3):363–70.PubMed Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB. Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Curr Obes Rep. 2015;4(3):363–70.PubMed
2.
go back to reference Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012;13(3):275–86. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012;13(3):275–86.
3.
go back to reference Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J. Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk—a review of the literature. Eur J Clin Nutr. 2010;64(1):16.PubMed Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J. Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk—a review of the literature. Eur J Clin Nutr. 2010;64(1):16.PubMed
4.
go back to reference Phillips SD, Roberts WC. Comparison of body mass index among patients with versus without angiographic coronary artery disease. Am J Cardiol. 2007;100(1):18–22.PubMed Phillips SD, Roberts WC. Comparison of body mass index among patients with versus without angiographic coronary artery disease. Am J Cardiol. 2007;100(1):18–22.PubMed
5.
go back to reference Lavie CJ, De Schutter A, Parto P, Jahangir E, Kokkinos P, Ortega FB, et al. Obesity and prevalence of cardiovascular diseases and prognosis—the obesity paradox updated. Prog Cardiovasc Dis. 2016;58(5):537–47.PubMed Lavie CJ, De Schutter A, Parto P, Jahangir E, Kokkinos P, Ortega FB, et al. Obesity and prevalence of cardiovascular diseases and prognosis—the obesity paradox updated. Prog Cardiovasc Dis. 2016;58(5):537–47.PubMed
6.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–52.PubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–52.PubMed
7.
go back to reference Association AD. Diagnosis and classification of diabetes mellitus. Diab Care. 2008;31(Supplement 1):S55–60. Association AD. Diagnosis and classification of diabetes mellitus. Diab Care. 2008;31(Supplement 1):S55–60.
8.
go back to reference Parmar MS. Family history of coronary artery disease—need to focus on proper definition. Eur Heart J. 2003;24(22):2073.PubMed Parmar MS. Family history of coronary artery disease—need to focus on proper definition. Eur Heart J. 2003;24(22):2073.PubMed
9.
go back to reference Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K. Prevention of coronary heart disease in clinical practice. Summary of recommendations of the second joint task force of European and other societies on coronary prevention. J Hypertens. 1998;16(10):1407–14.PubMed Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K. Prevention of coronary heart disease in clinical practice. Summary of recommendations of the second joint task force of European and other societies on coronary prevention. J Hypertens. 1998;16(10):1407–14.PubMed
10.
go back to reference Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, et al. Waist circumference and cardiometabolic risk: a consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Obesity. 2007;15(5):1061–7.PubMed Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, et al. Waist circumference and cardiometabolic risk: a consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Obesity. 2007;15(5):1061–7.PubMed
11.
go back to reference Garnett S, Baur L, Cowell C. Waist-to-height ratio: a simple option for determining excess central adiposity in young people. Int J Obes. 2008;32(6):1028. Garnett S, Baur L, Cowell C. Waist-to-height ratio: a simple option for determining excess central adiposity in young people. Int J Obes. 2008;32(6):1028.
12.
go back to reference Members ATF, Hamm CW, Bassand J-P, Agewall S, Bax J, Boersma E, et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999–3054. Members ATF, Hamm CW, Bassand J-P, Agewall S, Bax J, Boersma E, et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999–3054.
13.
go back to reference Members ATF, Steg PG, James SK, Atar D, Badano LP, Lundqvist CB, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J. 2012;33(20):2569–619. Members ATF, Steg PG, James SK, Atar D, Badano LP, Lundqvist CB, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J. 2012;33(20):2569–619.
14.
go back to reference Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891–975.PubMed Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891–975.PubMed
15.
go back to reference Harris PJ, Behar VS, Conley MJ, Harrell FE, Lee KL, Peter RH, et al. The prognostic significance of 50% coronary stenosis in medically treated patients with coronary artery disease. Circulation. 1980;62(2):240–8.PubMed Harris PJ, Behar VS, Conley MJ, Harrell FE, Lee KL, Peter RH, et al. The prognostic significance of 50% coronary stenosis in medically treated patients with coronary artery disease. Circulation. 1980;62(2):240–8.PubMed
16.
go back to reference Sabah KMN, Chowdhury AW, Khan HLR, Hasan AH, Haque S, Ali S, et al. Body mass index and waist/height ratio for prediction of severity of coronary artery disease. BMC Res Notes. 2014;7(1):246.PubMedPubMedCentral Sabah KMN, Chowdhury AW, Khan HLR, Hasan AH, Haque S, Ali S, et al. Body mass index and waist/height ratio for prediction of severity of coronary artery disease. BMC Res Notes. 2014;7(1):246.PubMedPubMedCentral
17.
go back to reference Avci A, Fidan S, Tabakçı MM, Toprak C, Alizade E, Acar E, et al. Association between the Gensini score and carotid artery stenosis. Korean Circ J. 2016;46(5):639–45.PubMedPubMedCentral Avci A, Fidan S, Tabakçı MM, Toprak C, Alizade E, Acar E, et al. Association between the Gensini score and carotid artery stenosis. Korean Circ J. 2016;46(5):639–45.PubMedPubMedCentral
18.
go back to reference Gannot S, Fefer P, Kopel E, Kochkina K, Beigel R, Raanani E, et al. Higher Syntax score is not predictive of late mortality in “real-world” patients with multivessel coronary artery disease undergoing coronary artery bypass grafting. Israel Med Assoc J. 2014;16(12):764–7. Gannot S, Fefer P, Kopel E, Kochkina K, Beigel R, Raanani E, et al. Higher Syntax score is not predictive of late mortality in “real-world” patients with multivessel coronary artery disease undergoing coronary artery bypass grafting. Israel Med Assoc J. 2014;16(12):764–7.
19.
go back to reference Mirmiran P, Esmaillzadeh A, Azizi F. Detection of cardiovascular risk factors by anthropometric measures in Tehranian adults: receiver operating characteristic (ROC) curve analysis. Eur J Clin Nutr. 2004;58(8):1110.PubMed Mirmiran P, Esmaillzadeh A, Azizi F. Detection of cardiovascular risk factors by anthropometric measures in Tehranian adults: receiver operating characteristic (ROC) curve analysis. Eur J Clin Nutr. 2004;58(8):1110.PubMed
20.
go back to reference Rubinshtein R, Halon DA, Jaffe R, Shahla J, Lewis BS. Relation between obesity and severity of coronary artery disease in patients undergoing coronary angiography. Am J Cardiol. 2006;97(9):1277–80.PubMed Rubinshtein R, Halon DA, Jaffe R, Shahla J, Lewis BS. Relation between obesity and severity of coronary artery disease in patients undergoing coronary angiography. Am J Cardiol. 2006;97(9):1277–80.PubMed
21.
go back to reference Rossi R, Iaccarino D, Nuzzo A, Chiurlia E, Bacco L, Venturelli A, et al. Influence of body mass index on extent of coronary atherosclerosis and cardiac events in a cohort of patients at risk of coronary artery disease. Nutr Metab Cardiovasc Dis. 2011;21(2):86–93.PubMed Rossi R, Iaccarino D, Nuzzo A, Chiurlia E, Bacco L, Venturelli A, et al. Influence of body mass index on extent of coronary atherosclerosis and cardiac events in a cohort of patients at risk of coronary artery disease. Nutr Metab Cardiovasc Dis. 2011;21(2):86–93.PubMed
22.
go back to reference Stalls CM, Triplette MA, Viera AJ, Pathman DE, Cohen MG, Rossi JS. The association between body mass index and coronary artery disease severity: a comparison of black and white patients. Am Heart J. 2014;167(4):514–20.PubMed Stalls CM, Triplette MA, Viera AJ, Pathman DE, Cohen MG, Rossi JS. The association between body mass index and coronary artery disease severity: a comparison of black and white patients. Am Heart J. 2014;167(4):514–20.PubMed
23.
go back to reference Chen Y, Copeland WK, Vedanthan R, Grant E, Lee JE, Gu D, et al. Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia cohort consortium. Bmj. 2013;347:f5446.PubMedPubMedCentral Chen Y, Copeland WK, Vedanthan R, Grant E, Lee JE, Gu D, et al. Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia cohort consortium. Bmj. 2013;347:f5446.PubMedPubMedCentral
24.
go back to reference Squeri A, Gaibazzi N, Reverberi C, Caracciolo MM, Ardissino D, Gherli T. Ejection fraction change and coronary artery disease severity: a vasodilator contrast stress-echocardiography study. J Am Soc Echocardiogr. 2012;25(4):454–9.PubMed Squeri A, Gaibazzi N, Reverberi C, Caracciolo MM, Ardissino D, Gherli T. Ejection fraction change and coronary artery disease severity: a vasodilator contrast stress-echocardiography study. J Am Soc Echocardiogr. 2012;25(4):454–9.PubMed
25.
go back to reference Zaman T, Agarwal S, Anabtawi AG, Patel NS, Ellis SG, Tuzcu EM, et al. Angiographic lesion severity and subsequent myocardial infarction. Am J Cardiol. 2012;110(2):167–72.PubMed Zaman T, Agarwal S, Anabtawi AG, Patel NS, Ellis SG, Tuzcu EM, et al. Angiographic lesion severity and subsequent myocardial infarction. Am J Cardiol. 2012;110(2):167–72.PubMed
Metadata
Title
Correlation between overweightness and the extent of coronary atherosclerosis among the South Caspian population
Authors
Maryam Nabati
Mahmood Moosazadeh
Ehsan Soroosh
Hanieh Shiraj
Mahnaneh Gholami
Ali Ghaemian
Publication date
01-12-2020

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