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BODY COMPOSITION, FITNESS AND ALL-CAUSE MORTALITY IN PATIENTS WITH CORONARY HEART DISEASE FOLLOWING CARDIAC REHABILITATION
A1276 JACC April 1, 2014 Volume 63, Issue 12
Prevention Body Composition, Fitness and All-Cause Mortality in Patients with Coronary Heart Disease Following Cardiac Rehabilitation Moderated Poster Contributions Hall C Saturday, March 29, 2014, 10:15 a.m.-10:30 a.m.
Session Title: Prevention: Lipids I Abstract Category: 22. Prevention: Rehabilitation Presentation Number: 1130M-364B Authors: Alban De Schutter, Carl Lavie, Arthur Menezes, Eiman Jahangir, Richard Milani, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA Background: Studies of coronary heart disease (CHD) cohorts have associated higher body mass index (BMI), lean mass index (LMI) and body fat (BF) with improved survival (the “obesity paradox”), especially when associated with low cardiorespiratory fitness (CRF). Higher LMI could be beneficial even in individuals with preserved CRF. Methods: 1148 CHD patients post cardiac rehabilitation(CR) were divided into low and high BMI, age- and gender- adjusted BF (measured by the skinfold method), LMI (calculated as (1-BF) x BMI kg/m2 ) and CRF (measured by peak oxygen consumption on cardiopulmonary stress testing, cutoff 14 cc/kg/min). Mortality was analyzed after 1 to 161 months of follow-up (mean 6.4 years). Results: After adjustment for age, gender, ejection fraction (EF) and CRF, higher BMI, LMI and BF were all protective in the entire population [HR 0.48 (p<0.001), HR 0.51 (p=0.002) and HR 0.57 (p=0.004), respectively] and in subjects with low CRF (N=275; mortality 31.3%) [HR 0.40 (p<0.001), HR 0.55 (p=0.01) and HR 0.36 (p<0.001) for BMI, LMI and BF, respectively; Figure A]. In subjects with high CRF (N=873; mortality 9.5%), higher BMI and LMI were protective [HR 0.54 (p=.02), HR 0.50 (p=.01)]. BF was not significantly associated with lower mortality after adjustment for LMI [HR 0.88 (CI 0.55-1.40); see Figure B]. Conclusions: We found a BMI paradox, driven by LMI, in individuals with higher levels of CRF. We confirmed an obesity paradox by BF, LMI and BMI in individuals with lower CRF.
Prevention Body Composition, Fitness and All-Cause Mortality in Patients with Coronary Heart Disease Following Cardiac Rehabilitation Moderated Poster Contributions Hall C Saturday, March 29, 2014, 10:15 a.m.-10:30 a.m.
Session Title: Prevention: Lipids I Abstract Category: 22. Prevention: Rehabilitation Presentation Number: 1130M-364B Authors: Alban De Schutter, Carl Lavie, Arthur Menezes, Eiman Jahangir, Richard Milani, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA Background: Studies of coronary heart disease (CHD) cohorts have associated higher body mass index (BMI), lean mass index (LMI) and body fat (BF) with improved survival (the “obesity paradox”), especially when associated with low cardiorespiratory fitness (CRF). Higher LMI could be beneficial even in individuals with preserved CRF. Methods: 1148 CHD patients post cardiac rehabilitation(CR) were divided into low and high BMI, age- and gender- adjusted BF (measured by the skinfold method), LMI (calculated as (1-BF) x BMI kg/m2 ) and CRF (measured by peak oxygen consumption on cardiopulmonary stress testing, cutoff 14 cc/kg/min). Mortality was analyzed after 1 to 161 months of follow-up (mean 6.4 years). Results: After adjustment for age, gender, ejection fraction (EF) and CRF, higher BMI, LMI and BF were all protective in the entire population [HR 0.48 (p<0.001), HR 0.51 (p=0.002) and HR 0.57 (p=0.004), respectively] and in subjects with low CRF (N=275; mortality 31.3%) [HR 0.40 (p<0.001), HR 0.55 (p=0.01) and HR 0.36 (p<0.001) for BMI, LMI and BF, respectively; Figure A]. In subjects with high CRF (N=873; mortality 9.5%), higher BMI and LMI were protective [HR 0.54 (p=.02), HR 0.50 (p=.01)]. BF was not significantly associated with lower mortality after adjustment for LMI [HR 0.88 (CI 0.55-1.40); see Figure B]. Conclusions: We found a BMI paradox, driven by LMI, in individuals with higher levels of CRF. We confirmed an obesity paradox by BF, LMI and BMI in individuals with lower CRF.