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dc.contributor.authorVidal Pérez, Rafael Carlos 
dc.contributor.authorFranco-Gutiérrez, R.
dc.contributor.authorPérez Pérez, Alberto Jose 
dc.contributor.authorFranco Gutiérrez, Raul 
dc.contributor.authorGascón Vázquez, Alberto
dc.contributor.authorLópez López, Andrea 
dc.contributor.authorTesta Fernández, Ana 
dc.contributor.authorGonzález Juanatey, Carlos 
dc.date.accessioned2022-02-02T08:18:11Z
dc.date.available2022-02-02T08:18:11Z
dc.date.issued2019
dc.identifier.issn1949-8462
dc.identifier.otherhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354075/pdf/WJC-11-24.pdfes
dc.identifier.urihttp://hdl.handle.net/20.500.11940/16084
dc.description.abstractBACKGROUND: Obesity is a major health problem due to its high prevalence. The relationship between obesity and cardiovascular disease is unclear. Some studies agree that certain conditions associated with obesity, such as physical inactivity or cardiovascular risk factors, are responsible for cardiovascular risk excess among obese people. Carotid intima-media thickness and carotid plaques (CP) have been associated with cardiovascular adverse events in healthy populations, and recent data suggest a higher prevalence of subclinical carotid atherosclerosis in obese and metabolically unhealthy patients. However, there are no studies correlating subclinical atherosclerosis and adverse events (AE) in obese subjects. AIM: To determine the association between carotid disease and AE in obese patients with negative exercise echocardiography (EE). METHODS: From January 1, 2006 to December 31, 2010, 2000 consecutive patients with a suspicion of coronary artery disease were submitted for EE and carotid ultrasonography. Exclusion criteria included previous vascular disease, left ventricular ejection fraction < 50%, positive EE, significant valvular heart disease and inferior to submaximal EE. An AE was defined as all-cause mortality, myocardial infarction and cerebrovascular accident. Subclinical atherosclerosis was defined as CP presence according to Manheim and the American Society of Echocardiography Consensus. RESULTS: Of the 652 patients who fulfilled the inclusion criteria, 226 (34.7%) had body mass indexes >/= 30 kg/m(2), and 76 of them (33.6%) had CP. During a mean follow-up time of 8.2 (2.1) years, 27 AE were found (11.9%). Mean event-free survival at 1, 5 and 10 years was 99.1% (0.6), 95.1% (1.4) and 86.5% (2.7), respectively. In univariate analysis, CP predicted AE [hazard ratio (HR) 2.52, 95% confidence interval (CI) 1.17-5.46; P = 0.019]. In multivariable analysis, the presence of CP remained a predictor of AE (HR 2.26, 95%CI 1.04-4.95, P = 0.041). Other predictors identified were glomerular filtration rate (HR 0.98, 95%CI 0.96-0.99; P = 0.023), peak metabolic equivalents (HR 0.83, 95%CI 0.70-0.99, P = 0.034) and moderate mitral regurgitation (HR 5.02, 95%CI 1.42-17.75, P = 0.012). CONCLUSION: Subclinical atherosclerosis defined by CP predicts AE in obese patients with negative EE. These patients could benefit from aggressive prevention measures.en
dc.language.isoenges
dc.rightsAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subject.meshStroke*
dc.subject.meshMortality*
dc.subject.meshMyocardial Infarction*
dc.titleSubclinical carotid atherosclerosis predicts all-cause mortality and cardiovascular events in obese patients with negative exercise echocardiographyen
dc.typeArtigoes
dc.identifier.doi10.4330/wjc.v11.i1.24
dc.identifier.pmid30705740
dc.identifier.sophos35018
dc.issue.number1es
dc.journal.titleWORLD JOURNAL OF CARDIOLOGYes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Lugo, Cervo e Monforte de lemos - Complexo Hospitalario Universitario Lucus Augusti::Cardioloxíaes
dc.page.initial61es
dc.rights.accessRightsopenAccesses
dc.subject.decsinfarto de miocardio*
dc.subject.decsmortalidad*
dc.subject.decsaccidente cerebrovascular*
dc.subject.keywordHULAes
dc.typefidesArtículo Originales
dc.typesophosArtículo Originales
dc.volume.number11es


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