Study on correlation of obesity with short-term prognosis in acute myocardial infarction.
BACKGROUND
Obese patients with established coronary artery disease have reduced mortality compared to normal or low body mass index (BMI) patients. The reason for the relation is not yet clearly understood. We sought to evaluate the association of BMI and waist circumference (WC) at the time of presentation in patients with myocardial infarction (MI) with one-year adverse cardiac events.


METHODS
In this prospective cohort study, we included consecutive patients with acute MI admitted to a tertiary care hospital during a period of one year. Upon admission, BMI and WC were measured. Patients were followed-up for a period of one year and the primary composite outcome of death or non-fatal MI was correlated with BMI and WC categories.


RESULTS
There were 703 patients (males 559 (79.5%)). Combined non-fatal MI and death at one year was 128 (18.2%). Incidence of primary outcome was 25.0% in low BMI group, 19.9% in normal BMI group, 13.1% in overweight group, 13.4% in class I obese, and 11.1% in class II obese groups. In univariate analysis, the inverse correlation was significant (p value=0.007). In one-year follow-up period, 12.8% in high and 20.8% in normal WC groups had primary outcome (p value=0.01). Both BMI and WC lost their predictive value in multivariate analysis.


CONCLUSIONS
Low BMI and normal WC were associated with a worse short-term outcome in patients with acute MI. Neither BMI nor WC independently predicted cardiac events or death after acute MI.
Assistant Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India. Electronic address: drharidasanv@yahoo.com.
Vellani
V
Haridasan
Senior Resident, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
K F
KF
Rajesh
Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
C G
CG
Sajeev
Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
G
G
Rajesh
Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
Cicy
C
Bastion
Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
D
D
Vinayakumar
Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
P
P
Kadermuneer
Assistant Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
Dolly
D
Mathew
Assistant Professor, Department of Community Medicine, Government Medical College, Kozhikode, Kerala, India.
Biju
B
George
Professor and Head, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
M N
MN
Krishnan
D015992:Body Mass Index; D002423:Cause of Death / Q000639:trends; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
Body mass index; Myocardial infarction; Obesity paradox