Central obesity linked to obstructive CAD in women with stable chest pain

In postmenopausal women with stable chest pain undergoing invasive coronary angiography, central obesity may predict the development of obstructive coronary artery disease (CAD), according to a study.

Researchers used data from a nationwide registry including 659 women with chest pain aged >55 years. All women were undergoing elective invasive coronary angiography in the suspicion of CAD.

A total of 311 women (47.2 percent) developed obstructive CAD, which was defined as angiographic findings of ≥50 percent diameter stenosis with any major epicardial coronary artery.

The number of those with overall obesity (body mass index [BMI] ≥25 kg/m²) did not significantly differ between women with and without obstructive CAD (p=0.340). On the other hand, obstructive CAD was detected more frequently in women with vs without central obesity (waist circumference of ≥85 cm; 55.5 percent vs 41.0 percent; p<0.001). Body mass index was similar in women with and without obstructive CAD (p=0.373).

On multivariable analysis, central obesity was associated with a greater likelihood of obstructive CAD (odds ratio, 1.61, 95 percent CI, 1.10–2.34; p=0.013). This was not true for overall obesity (p=0.228).

The present data show that relative to overall obesity, central obesity is a better predictor of obstructive CAD in women with stable chest pain, according to the researchers.