Coronary artery diseaseMedical Therapies and Invasive Treatments for Coronary Artery Disease by Body Mass: The “Obesity Paradox” in the Get With The Guidelines Database
Section snippets
Methods and Results
The GWTG initiative has been previously described.9 Briefly, it is a national cardiovascular quality improvement project, using a point-of-service, interactive, Internet-based Patient Management Tool (Outcome, Cambridge, Massachusetts). The CAD section of GWTG includes patients hospitalized for the entire spectrum of CAD: known CAD, unstable angina, non–ST-elevation myocardial infarction, ST-elevation myocardial infarction, or acute myocardial infarction, unspecified. All patients with these
Discussion
In this cohort of >130,000 hospitalizations for CAD, obesity was associated with development of premature CAD because patients with increased BMI presented with CAD at a significantly younger age. However, in these patients hospitalized with CAD, higher BMI was not associated with an increased mortality risk even after adjustment for multiple factors of prognostic significance. It also appears that increased body mass is associated with greater use of guideline-recommended therapies on
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Cited by (0)
The Get With The Guidelines (GWTG)—Coronary Artery Disease initiative is supported by an unrestricted educational grant from the Merck/Schering-Plough Pharmaceutical Partnership. The Duke Clinical Research Institute (Durham, North Carolina) receives funding from the American Heart Association as the GWTG analysis center. Dr. Cannon currently receives research grant support from Accumetrics, San Diego, California; AstraZeneca, Wilmington, Delaware; Merck, Whitehouse Station, New Jersey; Merck/Schering Plough Partnership, and Schering Plough, Kenilworth, New Jersey. Dr. Peterson has received research grant support from Schering Plough, Bristol-Myers Squibb, New York, New York; Sanofi-Aventis, Bridgewater, New Jersey, and Merck Schering. Dr. Fonarow has received research grants from GlaxoSmithKline, Philadelphia, Pennsylvania; Pfizer, New York, New York; and Amgen, Thousand Oaks, California.