Impact of Body Mass Index on In-Hospital Outcomes After Percutaneous Coronary Intervention for ST Segment Elevation Acute Myocardial Infarction

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Background The impact of body mass index (BMI) on outcomes after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) remains unclear. Methods and Results A total of 3,076 patients undergoing PCI for AMI within 48 h after symptom onset were studied. Patients were divided into 4 groups according to baseline BMI: lean (<20kg/m^2), normal weight (20.0-24.9kg/m^2), overweight (25.0-29.9kg/m^2) and obese (≥30.0kg/m^2). Obese patients were younger and had a higher frequency of diabetes mellitus, hyperlipidemia, hypertension and smoking. Lean patients were older, usually women and had a lower frequency of the aforementioned risk factors. Killip class on admission, renal insufficiency, and final Thrombolysis In Myocardial Infarction (TIMI) flow grade did not differ among the 4 groups. In lean, normal weight, overweight and obese patients, in-hospital mortality was 9.2%, 4.4%, 2.5% and 1.8%, respectively (p<0.01). Multivariate analysis showed that compared with normal weight patients, odds ratios for in-hospital death in lean, overweight and obese patients were 1.92, 0.79 and 0.40, respectively (p=NS). Independent predictors were age, Killip class on admission, renal insufficiency and final TIMI flow grade. Conclusion BMI itself had no impact on in-hospital mortality in patients undergoing primary PCI for AMI. The phenomenon 'obesity paradox' may be explained by the fact that obese patients were younger at presentation.
社団法人日本循環器学会の論文
2008-03-20

Impact of Body Mass Index on In-Hospital Outcomes After Percutaneous Coronary Intervention for ST Segment Elevation Acute Myocardial Infarction

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