Skip Navigation



European Heart Journal Advance Access published online on August 4, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl182
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
27/23/2755    most recent
ehl182v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Kennedy, L. M.A.
Right arrow Articles by Willenheimer, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kennedy, L. M.A.
Right arrow Articles by Willenheimer, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received September 8, 2005
Revised June 8, 2006
Accepted July 14, 2006

Clinical research

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

Linn M.A. Kennedy 1 *, Kenneth Dickstein 2, Stefan D. Anker 3, Margaret James 4, Thomas J. Cook 4, Krister Kristianson 5, and Ronnie Willenheimer 1

1 Department of Cardiology, Malmö University Hospital, Lund University, S-205 02 Malmö, Sweden
2 Cardiology Division, Stavanger University Hospital, University of Bergen, Norway
3 Division of Applied Cachexia Research, Department of Cardiology, Charité Campus Virchow Klinikum, Berlin, Germany
4 Merck & Co., Whitehouse Station, NJ, USA
5 Department of Clinical Pharmacology, Institution for Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden

* To whom correspondence should be addressed.
Linn M.A. Kennedy, E-mail: linn.kennedy{at}med.lu.se


  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.

Keywords: Coronary artery disease; Acute myocardial infarction; Weight-change; Prognosis; Mortality.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
B. Riegel, D. K. Moser, S. D. Anker, L. J. Appel, S. B. Dunbar, K. L. Grady, M. Z. Gurvitz, E. P. Havranek, C. S. Lee, J. Lindenfeld, et al.
State of the Science: Promoting Self-Care in Persons With Heart Failure: A Scientific Statement From the American Heart Association
Circulation, September 22, 2009; 120(12): 1141 - 1163.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. C. Madala, B. A. Franklin, A. Y. Chen, A. D. Berman, M. T. Roe, E. D. Peterson, E. M. Ohman, S. C. Smith Jr, W. B. Gibler, P. A. McCullough, et al.
Obesity and Age of First Non-ST-Segment Elevation Myocardial Infarction
J. Am. Coll. Cardiol., September 16, 2008; 52(12): 979 - 985.
[Abstract] [Full Text] [PDF]

Home page
 British Journal of Diabetes & Vascular DiseaseHome page
J. Wilding and N. Finer
Weight management and cardiovascular disease: implications of recent and ongoing clinical trials
The British Journal of Diabetes & Vascular Disease, July 1, 2008; 8(4): 170 - 176.
[Abstract] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.