Research Article The Relationship between Body Mass Index and the Severity of Coronary Artery Disease in Patients Referred for Coronary Angiography Anne B. Gregory, 1 Kendra K. Lester, 1 Deborah M. Gregory, 1,2 Laurie K. Twells, 1,3 William K. Midodzi, 1,2 and Neil J. Pearce 2,4 1 Department of Clinical Epidemiology, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada A1B 3V6 2 Department of Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada A1B 3V6 3 School of Pharmacy, Memorial University of Newfoundland, St. John’s, NL, Canada A1B 3V6 4 Eastern Health, St. John’s, NL, Canada A1B 3V6 Correspondence should be addressed to Deborah M. Gregory; dgregory@mun.ca Received 10 January 2017; Accepted 27 March 2017; Published 23 April 2017 Academic Editor: Robert Chen Copyright © 2017 Anne B. Gregory et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background and Aim. Obesity is associated with an increased risk of cardiovascular disease and may be associated with more severe coronary artery disease (CAD); however, the relationship between body mass index [BMI (kg/m 2 )] and CAD severity is uncertain and debatable. Te aim of this study was to examine the relationship between BMI and angiographic severity of CAD. Methods. Duke Jeopardy Score (DJS), a prognostic tool predictive of 1-year mortality in CAD, was assigned to angiographic data of patients ≥18 years of age (=8,079). Patients were grouped into 3 BMI categories: normal (18.5–24.9 kg/m 2 ), overweight (25.0–29.9 kg/m 2 ), and obese (≥30 kg/m 2 ); and multivariable adjusted hazard ratios for 1-year all-cause and cardiac-specifc mortality were calculated. Results. Cardiac risk factor prevalence (e.g., diabetes, hypertension, and hyperlipidemia) signifcantly increased with increasing BMI. Unadjusted all-cause and cardiac-specifc 1-year mortality tended to rise with incremental increases in DJS, with the exception of DJS 6 ( < 0.001). Afer adjusting for potential confounders, no signifcant association of BMI and all-cause (HR 0.70, 95% CI .48–1.02) or cardiac-specifc (HR 1.11, 95% CI .64–1.92) mortality was found. Conclusions. Tis study failed to detect an association of BMI with 1-year all-cause or cardiac-specifc mortality afer adjustment for potential confounding variables. 1. Introduction Obesity is an independent risk factor for cardiovascu- lar disease (CVD) [1–5] and is associated with advanced CVD requiring procedures such as percutaneous coronary intervention (PCI), reduction in life expectancy [6], and a higher mortality rate [3, 7, 8]. Weight loss has been associated with improvement in preexisting cardiovascular risk factors including hypertension (HTN), diabetes, and dys- lipidemia and mortality [9–12]. Other studies have reported improved clinical outcomes in overweight and obese patients treated for CVDs compared to normal weight patients, suggesting a paradoxical survival beneft. Tis efect has been reported in patients with diabetes [13], end-stage renal disease [14], HTN [15], and other conditions traditionally associated with poorer outcomes [15–23]. Obesity was pri- marily measured using BMI in the studies. Te mechanisms leading to this phenomenon, termed “obesity paradox,” are unclear. Te quantifcation of coronary artery disease (CAD) severity can be captured using coronary angiography (CA) [24]. Historically CAD has been categorized as single, double, and triple vessel and lef main disease, with luminal stenosis of either ≥50% (lef main) or ≥70% (other major epicardial vessels) used to defne signifcance [25]. Scoring systems to determine the severity of CAD and prognosis were developed to address the perceived limitations associated with stratifca- tion of patients with risk level variation [26–28]. Hindawi Cardiology Research and Practice Volume 2017, Article ID 5481671, 10 pages https://doi.org/10.1155/2017/5481671