Body Mass Index and Outcome of Acute Myocardial Infarction - Is There an Obesity Paradox?
BACKGROUND
Although there have been some studies focusing on the relationship between body mass index (BMI), coronary artery disease (CAD) and acute coronary syndrome, the clinical effects of BMI on outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) are not well known in a Taiwanese population.


METHODS
From January 2005 to December 2011, 1298 AMI patients who received PCI were enrolled from a single center in Taiwan. The patients were divided into 4 groups according to their BMI: underweight (BMI < 18.5 kg/m(2)); normal weight (18.5 ≤ BMI < 24 kg/m(2)); overweight (24 ≤ BMI < 27 kg/m(2)) and obese (BMI ≥ 27). All patients had been followed up for at least 12 months, and 30-day and 5-year all-cause and cardiovascular-cause mortality were compared among the study groups.


RESULTS
The patients in the underweight group had a lower 30-day survival rate than the other 3 groups, and the underweight and normal weight patients had a lower 5-year survival rate than the overweight and obese patients. The multivariate regression analysis showed that Killip class ≥ 2, non-use of statin, older age, hemoglobin < 12 g/dl and chronic kidney disease, but not BMI, are independent predictors of all-cause mortality.


CONCLUSIONS
In this present study, the major factors affecting long-term survival are lack of using statin and older age, but not obese paradox.


BACKGROUND
Acute myocardial infarction; Mortality; Obesity; Percutaneous coronary intervention; Survival.
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; Institute of Clinical Medicine; ; School of Medicine, National Yang-Ming University, Taipei;
Chin-Chang
CC
Cheng
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; School of Medicine, National Yang-Ming University, Taipei; ; Department of Physical Therapy, Fooyin University;
Wei-Chun
WC
Huang
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; School of Medicine, National Yang-Ming University, Taipei;
Kuan-Rau
KR
Chiou
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City;
Feng-Yu
FY
Kuo
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City;
Cheng-Hung
CH
Chiang
Department of Physical Therapy, Fooyin University;
Jin-Shiou
JS
Yang
Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Ko-Long
KL
Lin
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; School of Medicine, National Yang-Ming University, Taipei;
Shin-Hung
SH
Hsiao
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City;
Hwong-Ru
HR
Hwang
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City;
Guang-Yuan
GY
Mar
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; School of Medicine, National Yang-Ming University, Taipei;
Shoa-Lin
SL
Lin
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; School of Medicine, National Yang-Ming University, Taipei;
Chuen-Wang
CW
Chiou
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City; ; School of Medicine, National Yang-Ming University, Taipei;
Chun-Peng
CP
Liu