Beneficial effects of weight loss on MACE risk may come later for some

In a cohort of middle-aged individuals from South Korea, the initial weight loss at 4 years appears to contribute to an increased risk of major adverse cardiovascular events (MACEs), which may be explained by residual cardiovascular burden, according to a study. However, the risk increase disappears among individuals with sustained weight loss ≥ 6 years.

The study used data from the Korean Genome and Epidemiology Study and included 6,855 participants. Researchers evaluated the change in body mass index (BMI) according to group-based trajectory modelling (decreasing, stable, and increasing) from baseline through 4-, 6-, and 8-years of follow-up.

The primary outcome of MACE occurred in 350 (5.1 percent) participants over a mean follow-up of 10.2 years. The participants had a median age of 50 years.

Looking at the 4-year trajectory model, decreasing BMI trajectory carried a 1.41-fold higher risk of MACEs as compared with stable BMI trajectory (hazard ratio [HR], 1.41, 95 percent confidence interval [CI], 1.06–1.91).

Meanwhile, in the 6- and 8-year trajectory models, the association between decreasing BMI trajectory and elevated MACE risk disappeared, with HRs of 1.14 (95 percent CI, 0.81–1.61) and 0.98 (95 percent CI, 0.65–1.49), respectively.

Individuals in the decreasing BMI group also showed parallel improvements in cardiometabolic risk factors, although unfavourable risk burden remained up to 4 to 6 years.

The findings indicate that weight loss may have a possible lag effect on the risk of MACEs.