Abstract
Purpose: Low body mass index (BMI) is strongly associated with an increased long-term risk of cardiovascular events. However, there is no evidence of relationship between BMI and the degree of coronary atherosclerosis, and we evaluated the relationship using multivessel angioscopic observation.
Methods: A total of 89 patients with coronary artery disease who underwent angioscopic examination were analyzed. The patients were divided into four categories according to BMI levels: underweight: <20 kg/m2 (n = 7); normal weight: 20 to <25 kg/m2 (n = 40); overweight: 25 to <28 kg/m2 (n = 27); and obese: >28 kg/m2 (n = 15). The number of yellow plaques (NYP) through the observed coronary artery was counted and the color of each plaque was defined as grade 1 (light yellow), grade 2 (yellow), or grade 3 (intense yellow). The NYP per vessel and the maximum yellow grade (MYG) were compared between the four different groups of BMI.
Results: The severity of coronary atherosclerosis was significantly different: NYP per vessel (2.10 ± 1.16 vs. 1.53 ± 0.91 vs. 1.33 ± 0.79 vs. 1.10 ± 0.93, p = 0.024) and MYG (2.57 ± 0.54 vs. 2.25 ± 0.87 vs. 1.96 ± 0.90 vs. 1.93 ± 1.03, p = 0.046). Multivariate regression analysis showed that BMI (p = 0.024) independently correlate with the NYP per vessel.
Conclusions: Coronary atherosclerosis in underweight patients was more advanced than normal and overweight patients. Low BMI was independently related to progressive coronary atherosclerosis and that might be a characteristic of vulnerable patients.
