Association of waist circumference with long-term all-cause mortality and cardiac death in patients with a pacemaker: a retrospective study.

OBJECTIVES

To investigate the relationship between abdominal obesity and long-term prognosis in patients with a pacemaker.

METHODS

In the SUMMIT Study, patients were categorized by baseline waist circumference into obesity, normal, and lean groups. WC was measured at the midpoint between the last rib and hip bone after exhalation. Regular follow-ups were conducted, with all-cause mortality as the primary endpoint and cardiac death as the secondary endpoint.

RESULTS

In total, 492 patients were included in the analysis. The average baseline waist circumference was 84.2 ± 12.7 cm, and abdominal obesity was observed in 37.6% of patients. During a mean follow-up of 67.2 ± 17.5 months,71 death due to any cause (14.40%) and 24 cardiac death (4.87%) events occurred. All-cause mortality was associated with higher waist circumference (87.6 versus 83.6 cm, P = 0.014), but not body mass index (23.6 versus 23.5, P = 0.930). Multivariate Cox analysis showed compared with patients with abdominal obesity, lean patients had a significant lower risk in both all-cause mortality (HR 0.188, 95%CI 0.070-0.505, P = 0.001) and cardiac death (HR 0.097, 95% CI 0.012-0.792, P = 0.029).

CONCLUSIONS

Baseline waist circumference less than 80 cm for men and less than 75 cm for women in patients with a pacemaker had a significant lower risk in long-term all-cause mortality and cardiac death.