Author + information
Coutinho T, Goel K, Corrêa de Sa′ D, Carter RE, Hodge DO, Kragelund C, Kanaya AM, Zeller M, Park JS, Kober L, Torp-Pedersen C, Cottin Y, Lorgis L, Lee S-H, Kim Y-J, Thomas R, Roger VL, Somers VK, Lopez-Jimenez F. Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity.” J Am Coll Cardiol 2013;61:553–60.
A few errors in the Abstract have been noted. The correct median follow-up time is 2.4 years (IQR: 0.5 to 7.4 years). The reported follow-up time of 4.7 years is the mean, rather than the median, follow-up time. The correct number of deaths is 5,507, as outlined in the body of the paper, and the proportion of men in the study was 60%. The 4,699 deaths and 55% men reported in the Abstract reflected an earlier version of the paper, which included a smaller sample size. The hazard ratios reported in the Abstract represent the results of the waist circumference models, instead of the waist-hip ratio models.
The corrected Abstract is shown below:
Objectives: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based on a combination of body mass index (BMI) with measures of central obesity.
Background: In CAD patients, mortality has been reported to vary inversely with BMI (“obesity paradox”). In contrast, central obesity is directly associated with mortality. Because of this bidirectionality, we hypothesized that CAD patients with normal BMI but central obesity would have worse survival compared to individuals with other combinations of BMI and central adiposity.
Methods: We included 15,547 participants with CAD who were part of 5 studies from 3 continents. Multivariate stratified Cox-proportional hazard models adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity.
Results: Mean age was 66 years, 60% were men. There were 5,507 deaths over a median follow-up of 2.4 years (IQR: 0.5 to 7.4 years). Individuals with normal weight central obesity had the worst long-term survival: a person with BMI of 22 kg/m2 and waist circumference (WC) of 101 cm had higher mortality than a person with similar BMI but WC of 85 cm (HR: 1.10 [95% CI: 1.05 to 1.17]), than a person with BMI of 26 kg/m2 and WC of 85 cm (HR: 1.20 [95% CI: 1.09 to 1.31]), than a person with BMI of 30 kg/m2 and WC of 85 cm (HR: 1.61 [95% CI: 1.39 to 1.86]) and than a person with BMI of 30 kg/m2 and WC of 101 cm (HR: 1.27 [95% CI: 1.18 to 1.39), p < 0.0001 for all).
Conclusions: In patients with CAD, normal weight with central obesity is associated with the highest risk of mortality.
The authors apologize for these errors.
- 2013 American College of Cardiology Foundation