Article

The relation between body mass index (BMI) and coronary artery
disease (CAD) extension remains controversial. The aim of this study was to
evaluate the correlation between BMI and CAD extension documented by coronary
computed tomography angiography (CCTA). RESULTS: Prospective registry
including 1706 consecutive stable patients that performed CCTA (dual source
scanner) for the evaluation of CAD. The population was stratified by BMI: normal
530 (31.1%), overweight 802 (47.0%) and obesity 374 (21.9%). BMI was
significantly higher in patients with CAD (27.7 +/- 4.3 vs 26.8 +/- 4.3 kg/m(2),
p < 0.001); these patients were also older, more often male and had higher
prevalence of diabetes, hypertension and dyslipidemia. By multivariate analysis
(logistic regression) BMI remains an independent predictor of CAD (odds ratio
(OR) 1.03, 95% confidence interval (CI) 1.01-1.06; p = 0.012). Regarding the
severity of CAD, BMI was not significantly different among patients with and
without obstructive CAD (27.7 +/- 4.3 vs 27.2 +/- 4.3 kg/m(2), p = 0.120). In 319
patients (4516 segments; 4077 evaluable), a detailed atherosclerotic burden was
evaluated and compared among BMI classes, defined according to the presence of
plaque and the degree of stenosis. Obstructive CAD was identified in 16.9% of the
patients and 45.1% had non-obstructive CAD. The discriminative threshold for high
burden, established by the segment involvement score (SIS), was >5 segments with
plaque (15.4% patients). The prevalence of SIS >5 among the BMI classes was:
18.7%, 13.7% and 13.6% for normal, overweight and obesity respectively (p values
for the specific classes versus all other patients: 0.241, 0.450 and 0.663).
CONCLUSIONS: In this population of stable patients undergoing CCTA for suspected
CAD, BMI was an independent predictor of its presence, but was not correlated
with the coronary disease severity.
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Langue : ANGLAIS