Coronary artery disease in patients with body mass index ≥30 kg/m2: a retrospective chart analysis

• Main Authors: Hassan Alkhawam (Author), James Nguyen (Author), Jason Sayanlar (Author), Robert Sogomonian (Author), Ronak Desai (Author), JoshPaul Jolly (Author), Neil Vyas (Author), Umer Syed (Author), Maher Homsi (Author), David Rubinstein (Author)
• Format: Book
• Published: Greater Baltimore Medical Center, 2016-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2000-9666; 10.3402/jchimp.v6.31483
• Keywords: coronary artery disease; obesity; body mass index≥30; obstructive CAD; dyslipidemia; smoking; hypertension; Internal medicine; RC31-1245
• Source: Journal of Community Hospital Internal Medicine Perspectives, Vol 6, Iss 3, Pp 1-4 (2016)

Objective: In this study, we evaluated obesity as a single risk factor for coronary artery disease (CAD), along with the synergistic effect of obesity and other risk factors. Methods: A retrospective study of 7,567 patients admitted to hospital for chest pain from 2005 to 2014 and underwent cardiac catheterization. Patients were divided into two groups: obese and normal with body mass index (BMI) calculated as ≥30 kg/m2 and <25, respectively. We assessed the modifiable and non-modifiable risk factors in obese patients and the degree of CAD. Results: Of the 7,567 patients who underwent cardiac catheterization, 414 (5.5%) had a BMI ≥30. Of 414 obese patients, 332 (80%) had evidence of CAD. Obese patients displayed evidence of CAD at the age of 57 versus 63.3 in non-obese patients (p<0.001). Of the 332 patients with CAD and obesity, 55.4% had obstructive CAD versus 44.6% with non-obstructive CAD. In obese patients with CAD, male gender and history of smoking were major risk factors for development of obstructive CAD (p=0.001 and 0.01, respectively) while dyslipidemia was a major risk factor for non-obstructive CAD (p=0.01). Additionally, obese patients with more than one risk factor developed obstructive CAD compared to non-obstructive CAD (p=0.003). Conclusion: Having a BMI ≥30 appears to be a risk factor for early development of CAD. Severity of CAD in obese patients is depicted on non-modifiable and modifiable risk factors such as the male gender and smoking or greater than one risk factor, respectively.