Obesity and Age of First Non–ST-Segment Elevation Myocardial Infarction
Mohan C. Madala, MD*,
Barry A. Franklin, PhD*,
Anita Y. Chen, MS ,
Aaron D. Berman, MD, FACC*,
Matthew T. Roe, MD,
Eric D. Peterson, MD, FACC,
E. Magnus Ohman, MD, FACC,
Sidney C. Smith, Jr, MD, FACC ,
W. Brian Gibler, MD ,
Peter A. McCullough, MD, FACC*,* for the CRUSADE Investigators
* Department of Medicine, Divisions of Cardiology, Nutrition, and Preventive Medicine, William Beaumont Hospital, Royal Oak, Michigan
Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
University of North Carolina School of Medicine, Chapel Hill, North Carolina
University of Cincinnati College of Medicine, Cincinnati, Ohio
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Figure 1 Mean ± SD of Patient Age of First NSTEMI for Men and Women Across BMI Categories
p < 0.0001 for both linear trends. BMI = body mass index; NSTEMI = non–ST-segment elevated myocardial infarction.
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Figure 2 Rates of Conventional Cardiac Risk Factors According to BMI Group
Family history (Hx) of coronary disease was defined as reported history of myocardial infarction or coronary artery disease (CAD) in a parent or sibling before age 55 years. Hypertension was defined as systolic blood pressure >140 mm Hg, diastolic blood pressure >90 mm Hg on repeated measurements, or hypertension chronically treated with antihypertensive medications. Diabetes mellitus was defined as existing diagnosis of diabetes or current use of insulin or oral hypoglycemic agents. Dyslipidemia is defined as total cholesterol >200 mg/dl or current use of statin therapy. p < 0.0001 linear trend. BMI = body mass index.
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Figure 3 Measured Mean Lipid Values Stratified by BMI Group at Time of Presentation of NSTEMI
High-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and serum triglycerides are presented with median and 25th and 75th percentile values. p < 0.001 for each linear trend.
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Figure 4 Factors Independently Associated With a >3-Year Reduction in the Patient Age at Which First NSTEMI Occurred in the CRUSADE Registry
The referent group for BMI comparisons is 18.6 to 25.0 kg/m2. The overall mean age of first NSTEMI was 66.1 ± 14.4 years. FHx CAD = family history of coronary disease defined as reported history of myocardial infarction or coronary artery disease in a parent or sibling before age 55 years; other abbreviations as in Figure 1.
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