Why the study?
Does baseline body mass index and high-sensitivity C-reactive protein concentration predict all-cause and cardiovascular mortality in Chinese patients with coronary artery disease?
Cohort (n=1,871)
Yes
Does baseline body mass index and high-sensitivity C-reactive protein concentration predict all-cause and cardiovascular mortality in Chinese patients with coronary artery disease?
Hazard Ratio: 3.41 (95% CI 1.49–7.8)
In Chinese patients with coronary artery disease, a J-shaped association between BMI and mortality is primarily driven by patients with elevated hsCRP, suggesting low-grade inflammation modifies the obesity paradox.
BACKGROUND: To investigate single and joint associations of body mass index (BMI) and serum high-sensitivity C-reactive protein (hsCRP) with death. METHODS: The study included 1871 coronary artery disease (CAD) patients aged 40-85 year-old recruited from 2008 to 2011. Cox regression models were used to estimate the association of BMI and hsCRP with mortality. The data was analyzed in 2014. RESULTS: During 3.1 years follow-up, 141 deaths were recorded, 110 died of cardiovascular disease (CVD). After adjustment of major CVD risk factors, there was a J-shaped association between BMI and all-cause and CVD mortality, and a positive association between hsCRP and mortality. The J-shaped association of BMI with mortality was present among patients who never smoked or with elevated hsCRP (≥3.0 mg/L). Compared with overweight (BMI 24-27.9 kg/m2) patients with normal hsCRP (<3.0 mg/L), obese patients (BMI≥28 kg/m2) with elevated hsCRP had a 3.41-fold risk of all-cause mortality (95% CI 1.49-7.80) and a 3.50-fold risk of CVD mortality (1.40-8.75), lean patients (BMI<24 kg/m2) with elevated hsCRP concentration had a 2.54-fold risk of all-cause mortality (1.36-4.74) and a 2.36-fold risk of CVD mortality (1.19-4.70). CONCLUSIONS: The association pattern between baseline BMI and mortality changed among different baseline hsCRP concentrations, indicating that low-grade inflammation may be related to BMI and secondary prognosis of CAD.
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Ding et al. (2015) conducted a cohort in Coronary Artery Disease (n=1,871). Obesity (BMI ≥28 kg/m2) with elevated hsCRP (≥3.0 mg/L) vs. Overweight (BMI 24-27.9 kg/m2) with normal hsCRP (<3.0 mg/L) was evaluated on All-cause mortality (HR 3.41, 95% CI 1.49-7.80).
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