Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI

Seth Uretsky, Azhar Supariwala, Padmakshi Singh, Prashanth Atluri, Surinder S. Khokhar, Hari K. Koppuravuri, Rajeev Joshi, Anupa Mandeva, Alan Rozanski

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: While obesity has been shown to be associated with a worse mortality, an "obesity paradox"-lower mortality in obese patients-has been noted among many patients with coronary artery disease (CAD). The extent to which an obesity paradox operates among patients with only suspected CAD, is not well determined. Methods and Results: A total of 3,673 patients (60 ± 13 years, 36% males) with no history of heart disease and a normal stress SPECT were included in this study. Normal weight was defined as BMI of 18.5-24.9 kg · m2; overweight 25-29.9 kg · m2, obese >30 kg · m2. The baseline clinical risk factors were recorded for each patient. The end point of the study was all-cause mortality. Of patients 942 (26%) were normal weight, 1,261 (34%) were overweight, and 1,470 (40%) were obese. Mean patient follow-up was 7.5 ± 3 years. When compared to normal weight patients (event rate 3.2%/year), there was a lower incidence of death in the overweight (event rate 1.5%/year, P < .0001) and the obese (event rate 1.2%/year, P < .0001) groups. After controlling for baseline risk factors, using a reference HR = 1 for normal weight patients, there was a lower risk of death in the overweight (HR = .54, 95% CI .43-.7) and the obese groups (HR = .49, 95% CI .38-.63). Conclusion: In patients without known cardiac disease and a normal stress SPECT, overweight and obese patients had a lower rate of all-cause mortality compared to normal weight patients over long-term follow-up. This study substantially extends the spectrum of patients in whom the obesity paradox is present.

Original languageEnglish (US)
Pages (from-to)390-397
Number of pages8
JournalJournal of Nuclear Cardiology
Volume17
Issue number3
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

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Single-Photon Emission-Computed Tomography
Coronary Artery Disease
Weights and Measures
Survival
Obesity
Mortality
Heart Diseases

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Uretsky, Seth ; Supariwala, Azhar ; Singh, Padmakshi ; Atluri, Prashanth ; Khokhar, Surinder S. ; Koppuravuri, Hari K. ; Joshi, Rajeev ; Mandeva, Anupa ; Rozanski, Alan. / Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI. In: Journal of Nuclear Cardiology. 2010 ; Vol. 17, No. 3. pp. 390-397.
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Uretsky, S, Supariwala, A, Singh, P, Atluri, P, Khokhar, SS, Koppuravuri, HK, Joshi, R, Mandeva, A & Rozanski, A 2010, 'Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI', Journal of Nuclear Cardiology, vol. 17, no. 3, pp. 390-397. https://doi.org/10.1007/s12350-010-9214-6

Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI. / Uretsky, Seth; Supariwala, Azhar; Singh, Padmakshi; Atluri, Prashanth; Khokhar, Surinder S.; Koppuravuri, Hari K.; Joshi, Rajeev; Mandeva, Anupa; Rozanski, Alan.

In: Journal of Nuclear Cardiology, Vol. 17, No. 3, 01.06.2010, p. 390-397.

Research output: Contribution to journalArticle

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T1 - Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI

AU - Uretsky, Seth

AU - Supariwala, Azhar

AU - Singh, Padmakshi

AU - Atluri, Prashanth

AU - Khokhar, Surinder S.

AU - Koppuravuri, Hari K.

AU - Joshi, Rajeev

AU - Mandeva, Anupa

AU - Rozanski, Alan

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Background: While obesity has been shown to be associated with a worse mortality, an "obesity paradox"-lower mortality in obese patients-has been noted among many patients with coronary artery disease (CAD). The extent to which an obesity paradox operates among patients with only suspected CAD, is not well determined. Methods and Results: A total of 3,673 patients (60 ± 13 years, 36% males) with no history of heart disease and a normal stress SPECT were included in this study. Normal weight was defined as BMI of 18.5-24.9 kg · m2; overweight 25-29.9 kg · m2, obese >30 kg · m2. The baseline clinical risk factors were recorded for each patient. The end point of the study was all-cause mortality. Of patients 942 (26%) were normal weight, 1,261 (34%) were overweight, and 1,470 (40%) were obese. Mean patient follow-up was 7.5 ± 3 years. When compared to normal weight patients (event rate 3.2%/year), there was a lower incidence of death in the overweight (event rate 1.5%/year, P < .0001) and the obese (event rate 1.2%/year, P < .0001) groups. After controlling for baseline risk factors, using a reference HR = 1 for normal weight patients, there was a lower risk of death in the overweight (HR = .54, 95% CI .43-.7) and the obese groups (HR = .49, 95% CI .38-.63). Conclusion: In patients without known cardiac disease and a normal stress SPECT, overweight and obese patients had a lower rate of all-cause mortality compared to normal weight patients over long-term follow-up. This study substantially extends the spectrum of patients in whom the obesity paradox is present.

AB - Background: While obesity has been shown to be associated with a worse mortality, an "obesity paradox"-lower mortality in obese patients-has been noted among many patients with coronary artery disease (CAD). The extent to which an obesity paradox operates among patients with only suspected CAD, is not well determined. Methods and Results: A total of 3,673 patients (60 ± 13 years, 36% males) with no history of heart disease and a normal stress SPECT were included in this study. Normal weight was defined as BMI of 18.5-24.9 kg · m2; overweight 25-29.9 kg · m2, obese >30 kg · m2. The baseline clinical risk factors were recorded for each patient. The end point of the study was all-cause mortality. Of patients 942 (26%) were normal weight, 1,261 (34%) were overweight, and 1,470 (40%) were obese. Mean patient follow-up was 7.5 ± 3 years. When compared to normal weight patients (event rate 3.2%/year), there was a lower incidence of death in the overweight (event rate 1.5%/year, P < .0001) and the obese (event rate 1.2%/year, P < .0001) groups. After controlling for baseline risk factors, using a reference HR = 1 for normal weight patients, there was a lower risk of death in the overweight (HR = .54, 95% CI .43-.7) and the obese groups (HR = .49, 95% CI .38-.63). Conclusion: In patients without known cardiac disease and a normal stress SPECT, overweight and obese patients had a lower rate of all-cause mortality compared to normal weight patients over long-term follow-up. This study substantially extends the spectrum of patients in whom the obesity paradox is present.

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