{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:27:19Z","timestamp":1790663239808,"version":"4.1.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,5,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prognosis based on body fat percentage (\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              %) in patients with coronary artery disease has not been extensively studied. We tested the hypothesis that patients with coronary artery disease and increased\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              % have a higher risk for major adverse cardiovascular events (\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              ) and that fat\u2010free mass is associated with better prognosis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We included 717 patients referred to cardiac rehabilitation after coronary artery disease events or procedures who underwent air displacement plethysmography to assess\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              %; 75% were men, with a mean age 61.4\u00b111.4\u00a0years and a mean body mass index of 30\u00b15.4\u00a0kg\/m\n              <jats:sup>2<\/jats:sup>\n              . Follow\u2010up was performed using a record linkage system. Patients were classified in sex\u2010specific quartiles of\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              % and fat\u2010free mass index. The composite outcome of\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              included acute coronary syndromes, coronary revascularization, stroke, or death from any cause. After a median follow\u2010up of 3.9\u00a0years, 201 patients had a\n              <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content>\n              . After adjusting for covariates, body mass index was not associated with\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              =0.12). However, the risk of\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              for those in the highest\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              % quartile was nearly double when compared with those in the lowest quartile (hazard ratio, 1.89; 95% confidence interval, 1.30\u20132.77;\n              <jats:italic>P<\/jats:italic>\n              =0.0008). In contrast, fat\u2010free mass was inversely associated with\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              . The risk of\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              for those in the fourth fat\u2010free mass quartile was lower (adjusted hazard ratio, 0.53; 95% confidence interval, 0.35\u20130.82;\n              <jats:italic>P<\/jats:italic>\n              =0.004), when compared with those in the first quartile.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In patients with coronary artery disease, there is no obesity paradox when measuring\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              % instead of body mass index.\n              <jats:styled-content style=\"fixed-case\">BF<\/jats:styled-content>\n              % is associated with a higher risk of\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              , whereas fat\u2010free mass is associated with a lower risk of\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              . Body mass index was not associated with\n              <jats:styled-content style=\"fixed-case\">MACEs<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.007505","type":"journal-article","created":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T09:20:09Z","timestamp":1525771209000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Association Between Adiposity and Lean Mass With Long\u2010Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox"],"prefix":"10.1161","volume":"7","author":[{"given":"Jose R.","family":"Medina\u2010Inojosa","sequence":"first","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virend K.","family":"Somers","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randal J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Jean","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Division of Health Sciences Research, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Gomez\u2010Ibarra","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Supervia","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Lopez\u2010Jimenez","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.068"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0395"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69251-9"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2010.5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm243"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e31828254fc"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-199512000-00016"},{"key":"e_1_3_3_9_2","first-page":"361","article-title":"The impact of requiring patient authorization for use of data in medical records research","volume":"47","author":"Yawn BP","year":"1998","unstructured":"Yawn BP, Yawn RA, Geier GR, Xia Z, Jacobsen SJ. 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