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Obesity and statins are predictive of enhanced coronary resistance artery dilation in patients undergoing cardiac surgery
Author(s) -
Cassuto James,
Feher Attila,
Bagi Zsolt
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.1185.9
Subject(s) - medicine , dilator , cardiology , obesity paradox , body mass index , obesity , coronary artery disease , coronary atherosclerosis , overweight
The obesity paradox, a poorly understood inverse relationship between body mass index (BMI) and morbidity and mortality, has been described in patients with ischemic heart disease. Bradykinin induced endothelium‐dependent dilation was assessed by videomicroscopy in ex vivo coronary arterioles from 64 patients undergoing heart surgery. Linear and multivariable logistic regressions were used to investigate the effects of obesity (BMI ≥ 30 kg/M2) and the influences of medications on vessel responses. The diameter of isolated coronary arterioles was similar between obese and non‐obese patients. Responses to bradykinin exhibited a trend towards enhanced dilation in obese patients (55±25 % vs. 46±27 %, P=0.20), with a 1.1% increase in dilator response per BMI unit. In multivariable analysis, obesity was determined to be a predictor of enhanced dilation (HR=5.00, 95% CI=1.18–21.13) adjusted for other risk factors. Statin administration independently predicted a greater coronary dilation (HR=7.98, CI=1.76–36.19), whereas other medications, such as ACE inhibitors, ARBs and diuretics were without significant effects. Thus, obesity and statin therapy are independently associated with enhanced dilator function of coronary arterioles in patients undergoing heart surgery, which may offer a potential mechanism for the better cardiovascular outcome described as the obesity paradox.