Cardiac catheterization in morbidly obese patients

Catheter Cardiovasc Interv. 2002 Jun;56(2):174-7. doi: 10.1002/ccd.10186.


The safety and findings of cardiac catheterization and coronary angiography in morbidly obese patients with suspected coronary heart disease (CHD) have not been fully examined in the modern era. From a database of 4,978 patients undergoing diagnostic cardiac catheterization, we identified 110 with morbid obesity (body mass > or = 145 kg and body mass index > or = 40 kg/m(2)). Relative to all the other patients in this database, morbidly obese patients had a lower prevalence of CHD (45% vs. 72%; P < 0.05), reflecting a higher prevalence of false positive noninvasive tests. Overall, noninvasive tests were only 75% sensitive and 39% specific for CHD in this group. Use of radial access (66%) and femoral closure devices (24%) was much more frequent in the morbidly obese cohort. Complications were no more frequent in the morbidly obese group, with major (0 vs. 0.9%) and minor (4.7% vs. 3.5%) adverse outcomes being similar to the rest of the database. We conclude that cardiac catheterization using the radial artery or a femoral closure device is a safe and effective method of evaluating CHD in morbidly obese patients. In contrast, noninvasive testing is frequently not definitive and may be misleading.

MeSH terms

  • Cardiac Catheterization*
  • Comorbidity
  • Contraindications
  • Coronary Disease / diagnosis*
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / epidemiology*
  • Echocardiography, Stress
  • Exercise Test
  • Humans
  • Middle Aged
  • Obesity, Morbid / epidemiology*
  • Predictive Value of Tests
  • Prevalence
  • Radionuclide Imaging
  • Retrospective Studies