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Cited by 49Cardiovascular Disease and AdiposityHealthcare Systems and Public HealthCardiovascular Function and Risk Factors

Myocardial infarction and coronary pathology in severely obese people examined at autopsy

Kortelainen, M-L·2002·International Journal of Obesity
DOI 10.1038/sj.ijo.0801852
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Abstract

Objective To find out the severity of coronary atherosclerosis and its relationship to body structure and adiposity in severely obese people with body mass index (BMI) > or = 35.0 kg/m(2) and to examine the incidence and characteristic features of myocardial infarction and other fatal coronary events in this population.Design Autopsy reports were analyzed, including data on age, height, weight, abdominal subcutaneous fat thickness, heart weight, coronary atherosclerosis, histopathology and toxicology. Myocardial collagen and arteriolar structure were examined by computerized image analysis.Subjects Forensic autopsy cases (n=166) with a BMI > or = 35.0 kg/m(2) examined in 1992-1998 were collected from the files of the Department of Forensic Medicine, University of Oulu, Finland.Results In a large number of the severely obese individuals, the coronary arteries were either lesion-free or only fatty streaks were observed (38% of men, 44% of women) and coronary thrombosis was rare (3.8% of men and 1.6% of women). Cardiac causes of death predominated, cardiomyopathy being the commonest. Myocardial infarction was the immediate cause of death in 14.4% of men and 12.9% of the women, and it was associated with increased heart size in men. Coronary atherosclerosis without any infarction had been determined as the cause of death in 8.6% of the men and 8.1% of the women. Abdominal subcutaneous fat thickness had a significant negative association with the severity of coronary atherosclerosis in the women, and a decrease in the arteriolar media/lumen ratio with increasing BMI was observed in the men.Conclusions A considerable number of severely obese people have only fatty streaks and no marked stenosis in their coronary arteries, even at an advanced age. The large amounts of subcutaneous adipose tissue in obese women may provide some protection against coronary lesion development, which could be an estrogen effect. Myocardial infarction in severely obese men is associated with cardiac hypertrophy. The significance of the BMI-related dilatation of the myocardial arterioles in men and its relationship to a remodelling of the epicardial arteries will require future investigations.

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Crossref · 10.1038/sj.ijo.0801852

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  • Central obesity is a risk marker, and probably a risk factor, for the development and progression of coronary artery disease.

    “Indeed, central obesity is undeniably a risk marker, and probably a risk factor for the development and progression of coronary artery disease (43, 105, 185–188, 229, 241, 328).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [187]

  • Autopsy series have shown cardiac hypertrophy plus a variable extent of coronary artery disease in obese and nonobese subjects.

    “However, autopsy series present the opportunity to study heart tissue from obese and nonobese subjects, and in general, these studies have shown cardiac hypertrophy plus a variable extent of coronary artery disease (9, 64, 91, 147, 185–188, 300).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [187]

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Authors
Kortelainen, M.-L.
Affiliations
University of Oulu (FI)
Corresponding author
Kortelainen, M-L
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2002-01
Volume
26
Issue
1
Pages
73-79
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/sj.ijo.0801852
OpenAlex
W2069140470
Cited by
49
References
31
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 4 · 2012: 1
FWCI
1.75
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
myocardial infarction, morbid obesity, coronary artery disease, coronary thrombosis, fatty streaks, cardiomyopathy, cardiac hypertrophy, subcutaneous abdominal fat, body mass index, estrogen protective effect, coronary artery stenosis, autopsy findings
MeSH terms
Abdomen, Adipose Tissue, Adult, Aged, Aged, 80 and over, Autopsy, Body Composition, Coronary Artery Disease, Coronary Vessels, Female, Finland, Humans, Male, Medical Records, Middle Aged, Myocardial Infarction, Obesity, Retrospective Studies, Sex Factors, Skinfold Thickness, Body Mass Index, Incidence

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