title: Impact of body mass index on in-hospital outcomes after percutaneous coronary intervention for ST segment elevation acute myocardial infarction.
abstract: BACKGROUND
  The impact of body mass index (BMI) on outcomes after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) remains unclear.
  
  
  RESULTS
  A total of 3,076 patients undergoing PCI for AMI within 48 h after symptom onset were studied. Patients were divided into 4 groups according to baseline BMI: lean (<20 kg/m(2)), normal weight (20.0-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)) and obese (>or=30.0 kg/m(2)). Obese patients were younger and had a higher frequency of diabetes mellitus, hyperlipidemia, hypertension and smoking. Lean patients were older, usually women and had a lower frequency of the aforementioned risk factors. Killip class on admission, renal insufficiency, and final Thrombolysis In Myocardial Infarction (TIMI) flow grade did not differ among the 4 groups. In lean, normal weight, overweight and obese patients, in-hospital mortality was 9.2%, 4.4%, 2.5% and 1.8%, respectively (p<0.01). Multivariate analysis showed that compared with normal weight patients, odds ratios for in-hospital death in lean, overweight and obese patients were 1.92, 0.79 and 0.40, respectively (p=NS). Independent predictors were age, Killip class on admission, renal insufficiency and final TIMI flow grade.
  
  
  CONCLUSIONS
  BMI itself had no impact on in-hospital mortality in patients undergoing primary PCI for AMI. The phenomenon ;obesity paradox' may be explained by the fact that obese patients were younger at presentation.
authors: Division of Cardiology, Yokohama City University Medical Center, Japan.
authors: Masami
authors: M
authors: Kosuge
authors: Kazuo
authors: K
authors: Kimura
authors: Sunao
authors: S
authors: Kojima
authors: Tomohiro
authors: T
authors: Sakamoto
authors: Masaharu
authors: M
authors: Ishihara
authors: Yujiro
authors: Y
authors: Asada
authors: Chuwa
authors: C
authors: Tei
authors: Shunichi
authors: S
authors: Miyazaki
authors: Masahiro
authors: M
authors: Sonoda
authors: Kazufumi
authors: K
authors: Tsuchihashi
authors: Masakazu
authors: M
authors: Yamagishi
authors: Mutsunori
authors: M
authors: Shirai
authors: Hisatoyo
authors: H
authors: Hiraoka
authors: Takashi
authors: T
authors: Honda
authors: Yasuhiro
authors: Y
authors: Ogata
authors: Hisao
authors: H
authors: Ogawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015992:Body Mass Index; D015331:Cohort Studies; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D009765:Obesity / Q000150:complications / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013851:Thinness / Q000150:complications / Q000473:pathology; D016896:Treatment Outcome