title: Impact of body mass index on short-term outcome after acute myocardial infarction: does excess body weight have a paradoxical protective role?
abstract: BACKGROUND
  Obesity is a risk factor for acute myocardial infarction (AMI), due in part to obesity-related conditions. However, the relation between BMI (body mass index) and outcome in patients with AMI has not been completely clarified. The aim of our study was to assess the impact of BMI on short-term outcome after AMI.
  
  
  METHODS
  We retrospectively studied 717 consecutive patients admitted to our Intensive Coronary Care Unit for AMI. The end-point of the study was all-cause mortality.
  
  
  RESULTS
  The mean age was 64+/-12 years. Mean BMI was 26+/-3.5 kg/m2. During follow-up 15 patients died. Non-survivors were significantly older than survivors (p<0.0001); BMI (p = 0.0027) and weight (p = 0.0002) were significantly lower in non-survivors than survivors; left ventricular dimensions (end-diastolic diameter: p = 0.0023; end-systolic diameter: p = 0.0019), the number of akinetic segments (p<0.0001) and contractile efficiency (p<0.0001) were also significantly lower in non-survivors. At Cox proportional univariate analysis low BMI (p = 0.0019), female sex (p = 0.0041), age (p<0.0001), left ventricular dimensions (end-diastolic diameter = 0.0040, end-systolic diameter = 0.0053), number of akinetic segments (p = 0.0001) and degree of left ventricular dysfunction (p = 0.0002) were significant predictors of prognosis. The prognostic power of BMI remained after adjustment for age (p<0.05), left ventricular dimensions (end-diastolic diameter: p<0.0042; end-systolic diameter p = 0.04), contractile efficiency (p = 0.0045) or number of akinetic segments (p = 0.0070).
  
  
  CONCLUSIONS
  Low BMI is an independent predictor of poor prognosis in the short-term outcome after AMI. The underlying mechanisms remain to be investigated.
authors.affiliation: Dipartimento di Scienze Biomediche e Chirurgiche, Sezione di Cardiologia, Università degli Studi di Verona, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Nicoletti
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Cicoira
authors.forename: Giorgio
authors.initials: G
authors.lastname: Morando
authors.forename: Chiara
authors.initials: C
authors.lastname: Benazzi
authors.forename: Daniele
authors.initials: D
authors.lastname: Prati
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morani
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Piero
authors.initials: P
authors.lastname: Zardini
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis