Abstract 14884: Visit-to-Visit Variability in Body Weight and Risk of Cardiovascular Outcomes: Insights From the Treating to New Targets Trial

Abstract

Introduction: Previous studies have demonstrated a relationship between body weight and cardiovascular events. However, whether visit-to-visit variability in body weight affects cardiovascular outcomes is not known. Hypothesis: Variability in body weight is associated with increase in the risk of cardiovascular events Methods: We evaluated patients enrolled in the TNT trial with at least one post baseline measurement of body weight. Visit-to-visit variability in body weight was evaluated using various measures of variability: Standard deviation (SD), average successive variability (ASV), coefficient of variation (CV), and variation independent of mean (VIM) with the first 2 measures used as the primary measures. Primary outcome was any coronary events (composite of coronary heart disease death, non-fatal MI, resuscitated cardiac arrest, revascularization or angina) with the secondary outcomes of any cardiovascular event (composite of any coronary event, cerebrovascular event, peripheral vascular disease or heart failure), death, MI or stroke. Results: Among the 9921 patients included in the analysis,in the adjusted model, each 1-SD (1.62 kg) increase in body weight variability (as measured by ASV) increased the risk of any coronary event by 6% (HR=1.06; 95% CI 1.04-1.08; P <0.0001), any cardiovascular event by 7% (HR=1.07; 95% CI 1.05-1.08; P <0.0001), death by 8% (HR=1.08; 95% CI 1.05-1.11; P <0.0001), myocardial infarction by 6% (HR=1.06; 95% CI 1.03-1.10; P = 0.0002) and stroke by 7% (HR=1.07; 95% CI 1.03-1.12; P=0.001) independent of treatment effect and mean body weight. The results were consistent with other variability measures. Conclusions: In subjects with coronary artery disease, visit-to-visit variability in body weight is a strong and independent predictor of cardiovascular events suggesting perhaps that the swings in body weight are harmful.