Body mass index and in-hospital outcomes in patient's ≥80 years with ST Elevation Myocardial Infarction. Results from low income country without coronary intervention

Abstract

BackgroundIn most scenarios from low/middle income countries, pharmacological approach for ST elevation Myocardial Infarction is still use. In these setting and increase proportion of elderly patients is awaited. So it is also expected to have older patients with suboptimal treatment and risk stratification. ObjectiveTo investigate the impact of the body mass index (BMI) on in-hospital outcomes in a cohort of elderly (≥80 years) patients, from a center without coronary intervention. MethodsPatient's ≥80 years of age admitted to our institution between June 2014 and May 2019 with STEMI, were divided according BMI tertiles (BMI tertile 1: ≪22.36 kg/m2, BMI tertile2: 22.36–25.71 kg/m2, and BMI tertile 3: ≫25.71 kg/m2). The primary endpoint was all-cause in-hospital mortality ResultsOut of 118 patients, 41 (34.74%) were women. Median age was 84.4 ± 3.5 years and median BMI 24.1 ± 3.7 kg/m2. Women had a higher BMI than men (24.4 ± 4.0 vs 24.0 ± 3.6; p: 0.535). All-cause mortality was 33.3%, 2.5%, and 15% for lower, middle, and higher BMI tertiles (p=0.002). To belong to BMI tertile 1 was associated with an increased all-cause mortality (OR: 5.15, 95% CI 1.84–14.28, p = 0.001); and in patients without administration of streptokinase (OR: 9.52, 95% CI 2.34–38.45, p = 0.001). ConclusionThis study reports association between lower BMI values and increased mortality in elderly patients with and without pharmacological reperfusion with streptokinase.