title: Impact of body mass index on outcomes after percutaneous coronary intervention in patients with acute myocardial infarction.
abstract: Obesity is a widespread problem, particularly in the cardiovascular disease population. Obese patients have a lower incidence of cardiovascular mortality after elective percutaneous coronary interventions (PCIs); however, there is a paucity of data in the acute myocardial infarction (AMI) setting. This study investigated the effects of body mass index (BMI) on outcomes after percutaneous coronary revascularization in patients with AMI. Patients were categorized into 3 groups based on their BMI, i.e., normal, overweight, or obese. Most patients undergoing primary PCI for AMI (70%) were overweight or obese. Obese patients were significantly younger and more often diabetic, hypertensive, and hyperlipidemic compared with other groups. Angiographically, there was no difference in presence of multivessel disease, final Thrombolysis In Myocardial Infarction grade 3 flow, and presence of thrombus or dissection. Mortality was significantly lower in the hospital at 6 and 12 months in the obese group. Multivariate analysis demonstrated age>70 years, final Thrombolysis In Myocardial Infarction grade<3 flow, history of peripheral vascular disease, and ejection fraction to be the strongest predictors of mortality at 12 months. In conclusion, our data show that obese patients with AMI have a lower risk for in-hospital, 6-month, and 12-month mortality and cardiovascular events than patients with a normal BMI.
authors.affiliation: Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, and University of Miami, FL, USA. lmehta@beaumont.edu
authors.forename: Laxmi
authors.initials: L
authors.lastname: Mehta
authors.forename: William
authors.initials: W
authors.lastname: Devlin
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
authors.forename: William W
authors.initials: WW
authors.lastname: O'Neill
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Skelding
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Judith A
authors.initials: JA
authors.lastname: Boura
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Grines
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015992:Body Mass Index; D017023:Coronary Angiography; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume; D016896:Treatment Outcome