Body-Weight Fluctuations and Outcomes in Coronary Disease
Body-Weight Fluctuations and Outcomes in Coronary Disease
复制标题
DOI：
10.1056/nejmoa1606148
复制
发表时间：
2017-04-06
影响因子：
158.5
通讯作者：
Waters, David D.
中科院分区：
文献类型：
--
作者：
Bangalore, Sripal;Fayyad, Rana;Waters, David D.
体重波动是无心血管疾病患者死亡和冠状动脉事件的危险因素。目前尚不清楚体重的变化是否会影响冠状动脉disease.METHODS患者的结局，我们确定了个体内体重从基线体重和随访的波动，并进行了事后分析的治疗新目标的试验，其中包括评估的疗效和安全性，降低低密度脂蛋白胆固醇水平与阿托伐他汀。主要结局是任何冠状动脉事件（冠心病死亡、非致死性心肌梗死、心脏骤停复苏、血运重建或心绞痛的复合终点）。次要结局为任何心血管事件结果：在9509名参与者中，在校正了危险因素、基线血脂水平、平均体重和体重变化后，体重变异性每增加1个SD（根据平均连续变异性测量并用作时间依赖性协变量）与任何冠状动脉事件风险的增加相关（2091次活动;风险比，1.04; 95%置信区间[CI]，1.01至1.07; P=0.01），任何心血管事件（2727起事件;风险比，1.04; 95% CI，1.02至1.07; P = 0.01），
BACKGROUND Body-weight fluctuation is a risk factor for death and coronary events in patients without cardiovascular disease. It is not known whether variability in body weight affects outcomes in patients with coronary artery disease.METHODS We determined intraindividual fluctuations in body weight from baseline weight and follow-up visits and performed a post hoc analysis of the Treating to New Targets trial, which involved assessment of the efficacy and safety of lowering low-density lipoprotein cholesterol levels with atorvastatin. The primary outcome was any coronary event (a composite of death from coronary heart disease, non-fatal myocardial infarction, resuscitated cardiac arrest, revascularization, or angina). Secondary outcomes were any cardiovascular event (a composite of any coronary event, a cerebrovascular event, peripheral vascular disease, or heart failure), death, myocardial infarction, or stroke.RESULTS Among 9509 participants, after adjustment for risk factors, baseline lipid levels, mean body weight, and weight change, each increase of 1 SD in body-weight variability (measured according to average successive variability and used as a time-dependent covariate) was associated with an increase in the risk of any coronary event (2091 events; hazard ratio, 1.04; 95% confidence interval [CI], 1.01 to 1.07; P=0.01), any cardiovascular event (2727 events; hazard ratio, 1.04; 95% CI, 1.02 to 1.07; P