title: The Role of Anthropometry in Acute St-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention.
abstract: The aim of this study was to investigate the controversial influence of anthropometry on clinical severity and prognosis of acute ST-elevation myocardial infarction (STEMI). We prospectively analyzed 250 patients with acute STEMI treated with primary percutaneous coronary intervention (September 2011 – September 2012). They were grouped according to the following anthropometric parameters: body mass index (BMI) (<25.0, 25.0-29.9, ≥30.0 kg/m²), waist circumference (WC) (<102/88, ≥102/88 cm), waist-to-hip ratio (WHR) (<0.90/0.85, ≥0.90/0.85) and waist-to-height ratio (WHtR) (<53/49, 53/49-62/57, ≥63/58). The groups were analyzed by baseline, as well as severity (clinical, laboratory, echocardiography, coronary angiography, in-hospital complications) and prognostic parameters (major adverse cardiovascular events and sick leave duration during 12-month follow up). Patients with BMI <25.0 kg/m2 had the highest rates of dyspnea and those with BMI ≥30.0 kg/m² had the longest hospitalization and widest stents; patients with WHR ≥0.90/0.85 had higher rates of significantly stenosed proximal/middle coronary segments, while those with WHtR ≥63/58 had the highest rates of heart failure and total in-hospital complications (p<0.05). BMI <25.0 kg/m2 increased (odds ratio (OR) 2.00, confidence interval (CI) [1.09-3.68], p=0.026) and BMI 25.0-29.9 kg/m2 reduced (OR 0.52, CI [0.30-0.91], p=0.022) the risk of dyspnea; WHR≥0.90/0.85 increased the risk of significant proximal/middle coronary segment stenosis (OR 3.34, CI [1.13-9.86], p=0.029) and WHtR ≥63/58 the risk of heart failure (OR 2.05, CI [1.13-3.71], p=0.017) and total in-hospital complications (OR 1.94, CI [1.13-3.33], p=0.017) (p<0.05). In conclusion, WHR and WHtR are better anthropometric parameters than BMI in predicting acute STEMI severity, while WC has no influence on it. Anthropometry has no influence on prognosis.
authors.affiliation: Department of Internal Medicine and Dialysis, Zagreb-East Health Center, Zagreb, Croatia
authors.forename: Marko
authors.initials: M
authors.lastname: Mornar Jelavić
authors.affiliation: Coronary Care Unit, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
authors.forename: Zdravko
authors.initials: Z
authors.lastname: Babić
authors.affiliation: Cardiac Catheterization Laboratory, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Pintarić
authors.affiliation: Department of Kinesiologic Anthropology, Faculty of Kinesiology, Zagreb, Croatia
authors.forename: Marjeta
authors.initials: M
authors.lastname: Mišigoj-Duraković
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D015607:Stents; D055105:Waist Circumference; D065927:Waist-Height Ratio; D049629:Waist-Hip Ratio
keywords: Anthropometry; Obesity; Myocardial infarction; Percutaneous coronary intervention; Sick leave