Effect of overweight and obesity on cardiovascular events in asymptomatic aortic stenosis: a SEAS substudy (Simvastatin Ezetimibe in Aortic Stenosis).

Abstract

OBJECTIVES:

This study investigated whether overweight and obesity impacted outcome in patients with aortic valve stenosis (AS).

BACKGROUND:

Increased body mass index (BMI) is a strong predictor of higher cardiovascular (CV) morbidity and mortality in the general population but not among patients undergoing heart surgery.

METHODS:

Cardiovascular events in 1,664 patients with initially asymptomatic AS were recorded during a mean of 4.3 years of follow-up in the SEAS (Simvastatin Ezetimibe in Aortic Stenosis) study. Patients were grouped according to baseline BMI class.

RESULTS:

Overweight (n = 737) and obese patients (n = 334) had higher prevalence of hypertension, more abnormal left ventricular geometry, and lower stress-corrected midwall shortening throughout the study compared with normal weight patients (all p < 0.01). The AS progression rate did not differ between BMI classes. In univariate Cox regression, overweight was associated with a 17% to 22% lower rate of AS-related (p = 0.04) and ischemic CV events (p = 0.05). In multivariate analyses, adjusting for AS severity and differences in baseline characteristics, overweight had no significant influence on the rate of ischemic CV or AS-related events, whereas overweight and obesity had 46% and 67% higher rate of total mortality and 42% and 69% higher rate of combined hospital stay for heart failure and death from any cause, respectively, compared with normal weight patients (all p < 0.05).

CONCLUSIONS:

In patients with initially asymptomatic AS participating in the SEAS study, overweight and obesity did not influence AS progression or rate of AS-related or ischemic CV events but were both associated with increased mortality.

• Authors: Barbara P Rogge, Dana Cramariuc, Mai Tone Lønnebakken, Christa Gohlke-Bärwolf, John B Chambers, Kurt Boman, Eva Gerdts
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 62 Issue 18 Pg. 1683-1690 (Oct 29 2013) ISSN: 1558-3597 [Electronic] United States
• PMID: 23770175 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Aortic Valve Stenosis (epidemiology)
• Disease Progression
• Female
• Follow-Up Studies
• Heart Failure (epidemiology)
• Heart Ventricles (diagnostic imaging)
• Humans
• Hypertension (epidemiology)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Multivariate Analysis
• Obesity (epidemiology)
• Overweight (epidemiology)
• Prospective Studies
• Ultrasonography
• Ventricular Function, Left