title: Comparison of 2-year mortality according to obesity in stabilized patients with type 2 diabetes mellitus after acute myocardial infarction: results from the DIAMOND prospective cohort registry.
abstract: BACKGROUND
  After acute myocardial infarction (AMI), the replicated phenomenon of obesity paradox, i.e., obesity appearing to be associated with increased survival, has not been evaluated in stabilized (i.e., without clinical events within 1 month post AMI) Asian patients with diabetes mellitus (DM).
  
  
  METHODS
  Among 1192 patients in the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter registry between April 2010 and June 2012, 2-year cardiac and all-cause death were compared according to obesity (body mass index ≥25 kg/m(2)) in 1125 stabilized DM patients.
  
  
  RESULTS
  Compared with non-obese DM patients (62% of AMI patients), obese DM patients had: higher incidence of dyslipidemia (31 vs. 24%, P < 0.01); lower incidence of chronic kidney disease (26 vs. 33%) (P < 0.01); higher left ventricular ejection fraction after AMI (53 ± 11 vs. 50 ± 12%, P < 0.001); and lower 2-year cardiac and all-cause death occurrence (0.7 vs. 3.6% and 1.9 vs. 5.2%, both P < 0.01) and cumulative incidence in Kaplan-Meier analysis (P < 0.005, respectively). Likewise, both univariate and multivariate Cox hazard regression analyses adjusted for the respective confounders showed that obesity was associated with decreased risk of both cardiac [HR, 0.18 (95% CI 0.06-0.60), P = 0.005; and 0.24 (0.07-0.78), P = 0.018, respectively] and all-cause death [0.34 (0.16-0.73), P = 0.005; and 0.44 (0.20-0.95), P = 0.038].
  
  
  CONCLUSIONS
  In a Korean population of stabilized DM patients after AMI, non-obese patients appear to have higher cardiac and all-cause mortality compared with obese patients after adjusting for confounding factors.
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea. kbwon99@naver.com.
authors.forename: Ki-Bum
authors.initials: KB
authors.lastname: Won
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea. shur@dsmc.or.kr.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea. ds010042@gmail.com.
authors.forename: Yun-Kyeong
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea. hippsons@gmail.com.
authors.forename: Hyuck-Jun
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea. namcwcv@gmail.com.
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.affiliation: Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea. k5112@dsmc.or.kr.
authors.forename: Kwon-Bae
authors.initials: KB
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Konyang University Hospital, Daejeon, South Korea. janghobae@yahoo.co.kr.
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, South Korea. djchoi@snu.ac.kr.
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Chonnam National University Hospital, Gwangju, South Korea. cecilyk@hanmail.net.
authors.forename: Young-Keun
authors.initials: YK
authors.lastname: Ahn
authors.affiliation: Division of Cardiology, Yeungnam University Hospital, Daegu, South Korea. pjs@med.yu.ac.kr.
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Seoul National University Hospital, 28 Yeongeon-dong, Chongno-gu, Seoul, 110-744, South Korea. hyosoo@snu.ac.kr.
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, South Korea. yoorimbin@hanmail.net.
authors.forename: Rak-Kyeong
authors.initials: RK
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Yonsei University Severance Hospital, Seoul, South Korea. cdhlyj@yuhs.ac.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Pusan National University Yangsan Hospital, Yangsan, South Korea. junehongk@gmail.com.
authors.forename: Joon-Hong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea. krheart@hallym.or.kr.
authors.forename: Kyoo-Rok
authors.initials: KR
authors.lastname: Han
authors.affiliation: Division of Cardiology, Kyungpook National University Hospital, Daegu, South Korea. hspark@knu.ac.kr.
authors.forename: Hun-Sik
authors.initials: HS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Ajou University Hospital, Suwon, South Korea. sychoimd@hotmail.com.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Wonju Severance Christian Hospital, Wonju, South Korea. junghany@me.com.
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Division of Cardiology, Samsung Medical Center, Seoul, South Korea. hcgwon62@gmail.com.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Kwon
authors.affiliation: Division of Cardiology, Korea University Guro Hospital, Seoul, South Korea. swrha617@yahoo.co.kr.
authors.forename: Seung-Un
authors.initials: SU
authors.lastname: Rha
authors.affiliation: Division of Cardiology, Chungbuk National University Hospital, Cheongju, South Korea. khyungkyk@cbnu.ac.kr.
authors.forename: Kyung-Kuk
authors.initials: KK
authors.lastname: Hwang
authors.affiliation: Division of Cardiology, Korea University Anam Hospital, Seoul, South Korea. dslmd@kumc.or.kr.
authors.forename: Do-Sun
authors.initials: DS
authors.lastname: Lim
authors.affiliation: Division of Cardiology, Eulji University Hospital, Daejeon, South Korea. jkt@eulji.ac.kr.
authors.forename: Kyung-Tae
authors.initials: KT
authors.lastname: Jung
authors.affiliation: Division of Cardiology, Wonkwang University Hospital, Iksan, South Korea. oskcar@wonkwang.ac.kr.
authors.forename: Seok-Kyu
authors.initials: SK
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Chungnam National University Hospital, Daejeon, South Korea. myheart@cnu.ac.kr.
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Ulsan University Hospital, Ulsan, South Korea. sesim98@yahoo.co.kr.
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Daegu Catholic University Medical Center, Daegu, South Korea. kks7379@cu.ac.kr.
authors.forename: Kee-Sik
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D013318:Stroke Volume; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology