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Weight-change as a prognostic marker in 12 550 patients following acute myocardial infarction or with stable coronary artery disease.

Kennedy, Linn LU ; Dickstein, Kenneth; Anker, Stefan D; James, Margaret; Cook, Thomas J; Kristianson, Krister and Willenheimer, Ronnie LU (2006) In European Heart Journal 27. p.2755-2762
Abstract
Aims To examine the prognostic importance of weight-change in patients with coronary artery disease (CAD), especially following acute myocardial infarction (AMI). Methods and results In 4360 AMI patients (OPTIMAAL trial) without baseline oedema, we assessed 3-month weight-change, baseline body mass index (BMI), demographics, patient history, medication, physical examination, and biochemical analyses. Weight-change was defined as change >+/- 0.1 kg/baseline BMI-unit. Patients were accordingly categorized into three groups; weight-loss, weight-stability, and weight-gain. Our findings were validated in 4012 AMI patients (CONSENSUS II trial) and 4178 stable CAD patients (79% with prior AMI, 4S trial). Median follow-up was 2.7 years, 3... (More)
Aims To examine the prognostic importance of weight-change in patients with coronary artery disease (CAD), especially following acute myocardial infarction (AMI). Methods and results In 4360 AMI patients (OPTIMAAL trial) without baseline oedema, we assessed 3-month weight-change, baseline body mass index (BMI), demographics, patient history, medication, physical examination, and biochemical analyses. Weight-change was defined as change >+/- 0.1 kg/baseline BMI-unit. Patients were accordingly categorized into three groups; weight-loss, weight-stability, and weight-gain. Our findings were validated in 4012 AMI patients (CONSENSUS II trial) and 4178 stable CAD patients (79% with prior AMI, 4S trial). Median follow-up was 2.7 years, 3 months, and 4.4 years, respectively. In OPTIMAAL, 3-month weight-loss (vs. weight-stability) independently predicted increased all-cause death [n=471; hazard ratio (HR) 1.26; 95% CI 1.01-1.56; P=0.039] and cardiac death (n=299, HR 1.33, 95% CI 1.02-1.73, P=0.034). Weight-gain yielded risk similar to weight-stability (HR 1.07, P=0.592 and 0.97, P=0.866, respectively). In CONSENSUS II, 3-month weight-loss independently predicted increased mortality (HR 3.87, P=0.008). Weight-gain yielded risk similar to weight-stability (HR 1.11, P=0.860). In 4S, 1-year weight-loss independently predicted increased mortality (HR 1.44, P=0.004). Weight-gain conferred risk similar to weight-stability (HR 1.05, P=0.735). Conclusion In patients following AMI or with stable CAD, weight-loss but not weight-gain was independently associated with increased mortality risk. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
mortality, prognosis, weight-change, coronary artery disease, acute myocardial infarction
in
European Heart Journal
volume
27
pages
2755 - 2762
publisher
Oxford University Press
external identifiers
  • wos:000242472100009
  • scopus:33845321921
ISSN
1522-9645
DOI
10.1093/eurheartj/ehl182
language
English
LU publication?
yes
id
eff0838f-fedd-4669-8126-87d19c078006 (old id 160248)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16891382&dopt=Abstract
date added to LUP
2007-07-09 16:37:35
date last changed
2019-05-21 02:54:17
@article{eff0838f-fedd-4669-8126-87d19c078006,
  abstract     = {Aims To examine the prognostic importance of weight-change in patients with coronary artery disease (CAD), especially following acute myocardial infarction (AMI). Methods and results In 4360 AMI patients (OPTIMAAL trial) without baseline oedema, we assessed 3-month weight-change, baseline body mass index (BMI), demographics, patient history, medication, physical examination, and biochemical analyses. Weight-change was defined as change >+/- 0.1 kg/baseline BMI-unit. Patients were accordingly categorized into three groups; weight-loss, weight-stability, and weight-gain. Our findings were validated in 4012 AMI patients (CONSENSUS II trial) and 4178 stable CAD patients (79% with prior AMI, 4S trial). Median follow-up was 2.7 years, 3 months, and 4.4 years, respectively. In OPTIMAAL, 3-month weight-loss (vs. weight-stability) independently predicted increased all-cause death [n=471; hazard ratio (HR) 1.26; 95% CI 1.01-1.56; P=0.039] and cardiac death (n=299, HR 1.33, 95% CI 1.02-1.73, P=0.034). Weight-gain yielded risk similar to weight-stability (HR 1.07, P=0.592 and 0.97, P=0.866, respectively). In CONSENSUS II, 3-month weight-loss independently predicted increased mortality (HR 3.87, P=0.008). Weight-gain yielded risk similar to weight-stability (HR 1.11, P=0.860). In 4S, 1-year weight-loss independently predicted increased mortality (HR 1.44, P=0.004). Weight-gain conferred risk similar to weight-stability (HR 1.05, P=0.735). Conclusion In patients following AMI or with stable CAD, weight-loss but not weight-gain was independently associated with increased mortality risk.},
  author       = {Kennedy, Linn and Dickstein, Kenneth and Anker, Stefan D and James, Margaret and Cook, Thomas J and Kristianson, Krister and Willenheimer, Ronnie},
  issn         = {1522-9645},
  keyword      = {mortality,prognosis,weight-change,coronary artery disease,acute myocardial infarction},
  language     = {eng},
  pages        = {2755--2762},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal},
  title        = {Weight-change as a prognostic marker in 12 550 patients following acute myocardial infarction or with stable coronary artery disease.},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehl182},
  volume       = {27},
  year         = {2006},
}