Normal coronary arteries in patients with systolic heart failure who have higher body mass index
Background
Previous research has shown an association between higher body mass index (BMI) and lower mortality in patients with heart failure (HF).
Methods
We compared the prevalence of angiographic coronary artery disease (CAD) and risk factors in obese versus non-obese patients with HF. Eighty-four consecutive patients with systolic HF who underwent coronary angiography in a single institution were categorized by BMI into non-obese (BMI < 30, n = 42) and obese (BMI ≥ 30, n = 42) subjects.
Results
Chi-square analysis demonstrated a greater prevalence of normal coronary arteries and a lesser prevalence of CAD in the obese patients compared with the non-obese patients (64% [27/42] of obese patients vs 43% [18/42] non-obese patients had normal coronary arteries, P < .05). Among the obese patients, the subgroup with normal coronary arteries had a higher BMI (39 vs 32, P < .001) and was younger (51 vs 63 years, P < .005) compared with those with CAD. Although the prevalence of significant CAD (>50% diameter stenosis) was similar between obese and non-obese patients, the obese subgroup had a lower high-density lipoprotein (39 vs 49 mg/dL, P < .05).
Conclusions
Angiographically normal coronary arteries were more prevalent in patients with systolic HF who have a higher BMI.
Division of Cardiovascular Diseases, Department of Medicine, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Chicago, Illinois.
Reprint requests: Rohit R. Arora, MD, FACC, FAHA, Chicago Medical School, NCVAMC 3001, Green Bay Road, North Chicago, IL 60064.
ABSTRACT