Relation of Exercise Capacity and Body Mass Index to Mortality in Patients With Intermediate to High Risk of Coronary Artery Disease

Nils P. Johnson*, Edwin Wu, Robert O. Bonow, Thomas A. Holly

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

The relative impact of body mass index (BMI) and exercise capacity on mortality in patients with an intermediate to high likelihood of coronary artery disease (CAD) is not clear. Thus, the effect of BMI and exercise capacity on all-cause mortality in patients referred for stress myocardial perfusion imaging was investigated. The outcome of 2,119 patients undergoing exercise stress myocardial perfusion imaging from 1995 to 1999 was assessed. Patients lacked known CAD, but were at intermediate to high risk. Mortality outcome data were obtained from the Social Security Administration Death Master File. There were 183 deaths during an average follow-up of 8.4 ± 1.4 years. A Cox proportional hazards model identified age, Bruce protocol exercise time, BMI, male gender, and diabetes mellitus as significant predictors of all-cause mortality. In multivariate analysis, both exercise capacity and BMI correlated inversely with mortality, with higher chi-squared impact related to exercise capacity than BMI. In conclusion, both increased exercise capacity and BMI were associated with lower mortality in patients with an intermediate to high likelihood of CAD after controlling for confounding variables, supporting an inverse impact of BMI on mortality. The origin for this "obesity paradox" is unclear.

Original languageEnglish (US)
Pages (from-to)1028-1033
Number of pages6
JournalAmerican Journal of Cardiology
Volume102
Issue number8
DOIs
StatePublished - Oct 15 2008

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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