Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction.
The effect of body mass index (BMI) on outcomes after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not well known. In patients registered in the Korean Acute Myocardial Infarction Registry (KAMIR) between November 2005 and November 2007, 3824 STEMI patients who arrived at hospital within 12h after onset of chest pain and underwent primary PCI were analyzed, and divided into four groups according to their BMI: underweight (BMI<18.5 kg/m(2), n=129); normal weight (18.5 < or =BMI <23.0 kg/m(2), n=1253); overweight (23.0 < or =BMI <27.5 kg/m(2), n=1959); and obese (BMI > or =27.5 kg/m(2), n=483). In-hospital mortality, revascularization in 1 year, mortality in 1 year, and overall mortality were compared between groups. Overweight and obese group were significantly younger, had normal left ventricular ejection fraction, and were more likely to be men with a higher incidence of hypertension, diabetes, and hyperlipidemia. There were no significant differences in symptom-to-door time and door-to-balloon time between groups. Obese patients had significantly lower in-hospital and overall mortalities. Major adverse cardiac events showed a bimodal pattern. Obese STEMI patients treated with primary PCI were associated with lower mortality, which may be explained by better use of medical treatment, hemodynamic stability, and younger age.
Kang
Won Yu
WY
Chonnam National University Hospital, South Korea.
Jeong
Myung Ho
MH
Ahn
Young Keun
YK
Kim
Jong Hyun
JH
Chae
Shung Chull
SC
Kim
Young Jo
YJ
Hur
Seung Ho
SH
Seong
In Whan
IW
Hong
Taek Jong
TJ
Choi
Dong Hoon
DH
Cho
Myeong Chan
MC
Kim
Chong Jin
CJ
Seung
Ki Bae
KB
Chung
Wook Sung
WS
Jang
Yang Soo
YS
Rha
Seung Woon
SW
Bae
Jang Ho
JH
Cho
Jeong Gwan
JG
Park
Seung Jung
SJ
D000368:Aged; D000800:Angioplasty, Balloon; D015992:Body Mass Index; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D009765:Obesity / Q000150:complications*; D016896:Treatment Outcome