Coronary Microvascular Dysfunction Worsens with Increasing BMI

Coronary microvascular dysfunction was independently linked with elevated body mass index (BMI), according to results from a new study published in the Journal of the American College of Cardiology.  

The study authors followed a group of 827 consecutive patients undergoing coronary artery disease evaluation via cardiac stress positron emission tomography, looking for death, hospitalization for myocardial infarction, or heart failure. Patients were followed out to a median on 5.6 years.

Obesity, Coronary Microvascular Dysfunction and Risk: https://t.co/Rae4pNhWRD #JACC #cvCAD

Central Illustration c/o @JACCJournals pic.twitter.com/75MIenxbiJ

— American College of Cardiology (@ACCinTouch) August 7, 2018

According to the results, there was an independent J-shaped relationship between BMI and coronary flow reserve. In obese patients, coronary flow reserve decreased in a linear fashion with increasing BMI (P<0.0001). After adjustment, coronary flow reserve (but not BMI) was independently associated with events and for improved model discrimination. Obese patients with impaired coronary flow reserve had higher adjusted event rates (5.7% vs. 2.6%; P=0.002).  

“In patients referred for testing, coronary microvascular dysfunction was independently associated with elevated BMI and adverse outcomes and was a better discriminator of risk than BMI and traditional risk factors,” the researchers wrote. “Coronary flow reserve may facilitate management of obese patients beyond currently used markers of risk.” 

Very interesting study in @JACCJournals by @VTaqMD @RonBlankstein @DLBHATTMD: in #obese patients, increasing #BMI is associated with more #coronary #microvascular dysfxn and #CFR but not BMI is independently associated with CV eventshttps://t.co/Yp5cvi8xmP pic.twitter.com/ujvPWhTsDm

— Parham Eshtehardi MD (@CardioOBDoc) August 6, 2018

Coronary Microvascular Dysfunction is independently associated with elevated BMI & adverse outcomes, and was a better discriminator of risk than BMI and traditional risk factors. Great work @RonBlankstein @DLBHATTMD https://t.co/5m2k0UXkkr

— Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 (@DrMarthaGulati) August 6, 2018

Coronary Microvascular Dysfunction (CMD) associated with BMI and outcomes in obese patients!@JACCJournals @DLBHATTMD @JGrapsa @rafavidalperez @rladeiraslopes @MihaiTrofenciuc #Cardiology #Cardiotwitter #PublicHealth #Obesity https://t.co/jjL44X8UP0 pic.twitter.com/y4tpvDbM9d

— Konstantin Krychtiuk (@krychtiukmd) August 8, 2018

Source: Journal of the American College of Cardiology