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Obesity As a Risk Factor for Sustained Ventricular Tachyarrhythmias in MADIT II Patients
Author(s) -
PIETRASIK GRZEGORZ,
GOLDENBERG ILAN,
McNITT SCOTT,
MOSS ARTHUR J.,
ZAREBA WOJCIECH
Publication year - 2007
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2006.00680.x
Subject(s) - medicine , cardiology , ventricular fibrillation , sudden cardiac death , myocardial infarction , ventricular tachycardia , hazard ratio , implantable cardioverter defibrillator , risk factor , body mass index , population , sudden death , confidence interval , environmental health
Background: Obesity, as defined by body mass index ≥30 kg/m 2 , has been shown to be a risk factor for cardiovascular disease. However, data on the relationship between body mass index (BMI) and the risk of ventricular arrhythmias and sudden cardiac death are limited. The aim of this study was to evaluate the risk of ventricular tachyarrhythmias and sudden death by BMI in patients after myocardial infarction with severe left ventricular dysfunction. Methods : The risk of appropriate defibrillator therapy for ventricular tachycardia or ventricular fibrillation (VT/VF) by BMI status was analyzed in 476 nondiabetic patients with left ventricular dysfunction who received an implantable cardioverter defibrillator (ICD) in the Multicenter Automatic Defibrillator Implantation Trial‐II (MADIT II). Results : Mean BMI was 27 ± 5 kg/m 2 . Obese patients comprised 25% of the study population. After 2 years of follow‐up, the cumulative rates of appropriate ICD therapy for VT/VF were 39% in obese and 24% in nonobese patients, respectively (P = 0.014). In multivariate analysis, there was a significant 64% increase in the risk for appropriate ICD therapy among obese patients as compared with nonobese patients, which was attributed mainly to an 86% increase in the risk of appropriate ICD shocks (P = 0.006). Consistent with these results, the risk of the combined endpoint of appropriate VT/VF therapy or sudden cardiac death (SCD) was also significantly increased among obese patients (Hazard Ratio 1.59; P = 0.01). Conclusions : Our findings suggest that in nondiabetic patients with ischemic left ventricular dysfunction, a BMI ≥30 kg/m 2 is an independent risk factor for ventricular tachyarrhythmias.