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Abdominal obesity and the risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction

The purpose of this observational cohort study was to investigate the prevalence of abdominal obesity and its association with recurrent atherosclerotic cardiovascular disease (ASCVD) in patients after a first myocardial infarction. 22,882 patients were identified from the SWEDEHEART registry at a clinical revisit 4–10 weeks after their first myocardial infarction 2005–2014 who underwent an assessment of the waist circumference (WC), calculation of the body mass index (BMI). The primary outcome was recurrent ASCVD defined as any of the following: non-fatal MI, coronary heart disease death or fatal or non-fatal ischaemic stroke.

The majority of patients had abdominal obesity. The mean waist circumference for the population was 101.3 cm in men and 94.1 cm in women. The mean body mass index for the male and female population was 27.4 and 27.2 kg/m2, respectively. During a median follow-up of 3.8 years a total of 1232 men (7.3%) and 469 women (7.9%) experienced a recurrent ASCVD event. In the multivariable-adjustedmodel, risk of a recurrent ASCVD event was significantly increased in the fourth and fifth quintiles of WC (HR 1.21, CI 1.03–1.43 and HR 1.25, CI 1.04–1.50, respectively) compared with the first. There was a statistically significant interaction between gender and WC. Among men, the association was similar to the main results. Conversely, a U-shaped association was observed in women.

Thus, using WC measurements in the clinical setting after a first MI can identify patients at increased risk of recurrent ASCVD.


European Journal of Preventive Cardiology, January 20, 2020. Volume: 27 issue: 18, page(s): 1944-1952