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Cardiac risk factors and prevention
Original research
Lean body mass index prognostic value for cardiovascular events in patients with coronary artery disease
  1. Hirofumi Hioki1,
  2. Takashi Miura1,
  3. Hirohiko Motoki1,
  4. Hideki Kobayashi2,
  5. Masanori Kobayashi3,
  6. Hiroyuki Nakajima4,
  7. Hikaru Kimura5,
  8. Eiichiro Mawatari5,
  9. Hiroshi Akanuma6,
  10. Toshio Sato7,
  11. Souichirou Ebisawa1,
  12. Yusuke Miyashita1,
  13. Uichi Ikeda1
  14. On behalf of the SHINANO registry investigators
    1. 1Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan
    2. 2Department of Cardiology, Nagano Red Cross Hospital, Nagano, Japan
    3. 3Department of Cardiology, Matsumoto Kyoritsu Hospital, Matsumoto, Japan
    4. 4Department of Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan
    5. 5Department of Cardiology, Saku Central Hospital, Saku, Japan
    6. 6Department of Cardiology, Iida Municipal Hospital, Iida, Japan
    7. 7Department of Cardiology, Shinonoi General Hospital, Nagano, Japan
    1. Correspondence to Dr H Hioki, Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-0802, Japan; hhioki{at}shinshu-u.ac.jp

    Abstract

    Objective Little is known about the relationship between body composition indicators, including body mass index (BMI), fat mass index (FMI) and lean BMI (LBMI), and adverse outcomes after percutaneous coronary intervention (PCI) in Asian populations. The aim of this study was to clarify this relationship.

    Methods The SHINANO registry is a prospective, observational, multicenter cohort registry that enrolled 1923 consecutive patients with coronary heart disease (CHD) from August 2012 to July 2013; 66 patients were excluded because of missing data. We evaluated 1857 patients with CHD who underwent PCI (aged 70±11 years; 23% women; BMI 23.8±3.5 kg/m2; LBMI 18.3±1.8 kg/m2; FMI 5.4±2.2 kg/m2). Patients were divided into three groups, based on BMI, LBMI and FMI tertiles, to assess the prognostic value of the three indicators. The primary endpoint was major adverse cardiac events (MACE), including all cause death, non-fatal myocardial infarction and ischaemic stroke at 1 year.

    Results Over a 1 year follow-up period (1776 patients, 95.6%), the cumulative MACE incidence was 8.7% (161 cases). Using Kaplan–Meier analysis, the MACE incidence was significantly higher in patients with lower BMI values (13.4–22.2 kg/m2) (p=0.002) and lower LBMI values (11.6–17.6 kg/m2) (p<0.001); this trend was not observed for FMI. Multivariate Cox regression analysis showed that lower LBMI but not lower BMI values were predictive of a higher MACE incidence (HR 1.55; 95% CI 1.05 to 2.30).

    Conclusions Lower LBMI values are associated with adverse outcomes in an Asian population with CHD undergoing PCI. LBMI is a better predictor of MACE than BMI or FMI.

    Clinical trial registration UMIN-ID; 000010070.

    • CORONARY ARTERY DISEASE

    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

    https://doi.org/10.1136/heartasia-2015-010644

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