PP.LB03.24

Abstract

Objective: Obesity is a risk factor for cardiovascular disease and mortality, however several studies have been reported that patients with obesity who have admitted with acute myocardial infarction or have undergone percutaneous coronary intervention (PCI) have better clinical outcomes than their normal weight counterparts. The impact of body mass index (BMI) on myocardial perfusion and early clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients revascularized totally with manual thrombus aspiration remains unclear. Design and method: The study included 94 consecutive patients who underwent thrombus aspiration and stent-based primary PCI for STEMI between the years 2009 and 2013. Revascularization success was achieved in 83 patients with STEMI. These patients were divided into two groups according to BMI as normal weight (BMI < 25) or overweight (BMI > 25). At least 50% resolution of ST-segment up to 90 minutes after the procedure was defined as electrocardiographic good flow. Results: Among the 83 patients, 80% were overweight. While good flow observed in 79% of the patients, electrocardiographic perfusion success rates were similar in both groups. Overweight patients had better Killip class and higher initial left ventricular ejection fraction than normal weight patients. Angiographic characteristics were similar between the two groups except for the stent diameter which was higher in normal weight patients(Table 1). The usage of Glycoprotein IIb-IIIa antagonists was similar between the groups. In hospital and 30 day period, major adverse cardiac events (MACE) were not significantly different among the BMI categories.Conclusions: In the study, we demonstrated that despite similar myocardial reperfusion, patients with normal BMI had lower initial left ventricular ejection fraction and worse Killip class. The better results in overweight patients might indicate the presence of the phenomenon “obesity paradox” in patients who underwent thrombus aspiration in stent-based primary PCI for STEMI.