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Obese suffer acute coronary disease at a younger age and incur higher medical costs
Obese suffer acute coronary disease at a younger age and incur higher medical costs -- Posted by Sweet Zombie Jesus! on 06-03-05 10:06
OBJECTIVE: Obesity is an important risk factor for coronary artery
disease (CAD); however, its effect on acute coronary syndrome (ACS)
patients' long-term clinical and economic outcomes has not been
quantified. We assessed the impact of increasing body mass index (BMI)
on 10-year outcomes for ACS patients.
RESEARCH METHODS AND PROCEDURES: ACS patients with significant CAD
receiving an initial cardiac catheterization at Duke University Medical
Center between 1986 and 1997 were included. Patients with a BMI < 18.5
kg/m(2) were excluded; the remaining patients were classified by BMI as
normal, overweight, obese, or very obese. Medical costs were estimated
from a prior ACS clinical trial with costs adjusted to 1997 dollars and
discounted at 3% per annum.
RESULTS: There were 9405 patients with data available for analysis.
Follow-up was complete on >95% of patients. Patients who were obese at
baseline increased from 20% to 33% between 1986 and 1997. Increased BMI
was associated with younger age, multi-morbidity, and less severe CAD
at baseline. It was also associated with more clinical events, higher
cumulative inpatient medical costs, and significant differences in
unadjusted survival at 10 years. However, it was not associated with
differences in 10-year survival after adjusting for baseline
characteristic differences.
DISCUSSION: Obese ACS patients are younger and are hospitalized more
frequently during the first 10 years of their illness than are
non-obese patients. They also incur higher cumulative inpatient medical
costs, especially the very obese. These findings highlight the
opportunities for therapeutic benefit that aggressive weight management
and secondary prevention may provide this population.
Obes Res. 2002 Feb;10(2):83-91. Obesity and long-term clinical and
economic outcomes in coronary artery disease patients. Eisenstein EL,
Shaw LK, Nelson CL, Anstrom KJ, Hakim Z, Mark DB.The Outcomes Research
and Assessment Group, The Duke Clinical Research Institute, Durham,
North Carolina 27715, USA. eisen006@mc.duke.edu
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