Abstract
ObjectivesBeneficial effects of overweight and obesity on mortality after acute myocardial infarction (AMI) have been described as “Body Mass Index (BMI) paradox”. However, the effects of BMI is still on debate. We analyzed the association between BMI and 1-year clinical outcomes after AMI.MethodsAmong 13,104 AMI patients registered in Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) between November 2011 and December 2015, 10,568 patients who eligible for this study were classified into 3 groups according to BMI (Group 1; < 22 kg/m2, 22 ≤ Group 2 < 26 kg/m2, Group 3; ≥ 26 kg/m2). The primary end point was all cause death at 1 year.ResultsOver the median follow-up of 12 months, the event of primary end point occurred more frequently in the Group 1 patients than in the Group 3 patients (primary endpoint: adjusted hazard ratio [aHR], 1.537; 95% confidence interval [CI] 1.177 to 2.007, p = 0.002). Especially, cardiac death played a major role in this effect (aHR, 1.548; 95% confidence interval [CI] 1.128 to 2.124, p = 0.007).ConclusionsHigher BMI appeared to be good prognostic factor on 1-year all cause death after AMI. This result suggests that higher BMI or obesity might confer a protective advantage over the life-quality after AMI.
Highlights
The prevalence and socio-economic influence of obesity are dramatically increasing over the globe
Higher body mass index (BMI) appeared to be good prognostic factor on 1-year all cause death after acute myocardial infarction (AMI). This result suggests that higher BMI or obesity might confer a protective advantage over the lifequality after AMI
Some previous reports revealed that obesity paradox was observed but not reached to the significant difference after the multivariate analysis [10, 11], whereas other studies showed that obese patients with AMI had an improved prognosis after primary percutaneous coronary intervention (PCI) [9, 12, 13]
Summary
The prevalence and socio-economic influence of obesity are dramatically increasing over the globe. Obesity is well known to be related to aggravated cardiovascular disease [1,2,3,4,5,6]. Several studies showed restrictive impacts on cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI) [7,8,9]. Clinical effects of body mass index (BMI) after PCI in acute myocardial infarction (AMI) are still controversial. Some previous reports revealed that obesity paradox was observed but not reached to the significant difference after the multivariate analysis [10, 11], whereas other studies showed that obese patients with AMI had an improved prognosis after primary PCI [9, 12, 13]. The aim of the present study ought to evaluate the clinical outcome in patients with AMI undergoing PCI in accordance with weight status
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