{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:18:11Z","timestamp":1789010291861,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The effect of recent onset metabolic dysfunction on coronary artery disease (CAD) risk is poorly understood. We developed a large data set linking metabolic phenotypes and clinical outcomes to quantify CAD risks associated with adverse metabolic transition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Clinical parameters, measures of metabolic dysfunction components (diabetes, hypertension, elevated triglycerides, and low high\u2010density lipoprotein) and incident CAD were curated in a clinical cohort from a single quaternary medical center. Associations between body weight, metabolic abnormalities, and changes in metabolic health status were assessed for prevalent and incident CAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Increasing body mass index category, presence of metabolic dysfunction (&gt;2 components), and number of metabolic abnormalities were associated with prevalent CAD among 844\u2009841 individuals. In time\u2010to\u2010event analyses (N=69\u2009272), ~38% of subjects initially free of any metabolic dysfunction abnormality developed \u22651 abnormality over a 3\u2010year run\u2010in period. All metabolic abnormalities, whether new\u2010onset or preexisting, significantly increased 10\u2010year CAD event probability, and there was a progressive increase in 10\u2010year CAD risk with increasing burden of metabolic abnormalities. In models adjusting for metabolic dysfunction, 10\u2010year CAD risk increased for individuals with body mass index &gt;25\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (hazard ratio, 3.8). Compared with individuals with a body mass index of 25\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , any short\u2010term weight gain or loss of &gt;5% increased or decreased CAD risk, respectively, in individuals with a body mass index of 35\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In a large clinical cohort, the transition to metabolic dysfunction is common, occurs rapidly, and significantly increases incident CAD risk. The effect of body weight and weight loss on CAD risk is nonlinear. Interventions to prevent progression to metabolic dysfunction are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.037597","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T13:13:41Z","timestamp":1763990021000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Risk of Coronary Artery Disease Associated With Transitions in Metabolic Health in a Clinical Cohort of 69\u2009272"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2866-3562","authenticated-orcid":false,"given":"Megan M.","family":"Shuey","sequence":"first","affiliation":[{"name":"Vanderbilt University Medical Center","place":["Nashville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2775-7543","authenticated-orcid":false,"given":"Rebecca 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