In this study, we aimed to determine whether body mass index (BMI) is an independent predictor of in-hospital mortality in ST-segment elevation myocardial infarction (STEMI) patients and to assess the relationship between BMI and mortality.
Methods:
One thousand three hundred fifty-seven patients with STEMI were included to the study. Primary outcome was in-hospital mortality. The multivariable logistic regression was used to assess the relationship between BMI and in-hospital mortality using age, gender, diabetes mellitus, systolic blood pressure, heart rate, smoking status, serum creatinine and hemoglobin, type of STEMI, and Killip class as adjustment variables.
Results:
The frequency of in-hospital mortality was 14.7%. The mean BMI was found to be 28.2 ± 4.8 kg/m2. Considering the in-hospital mortality frequencies between the groups, mortality was observed in 61.7% of the BMI <20 kg/m2 group, 15.5% of the 20–25 kg/m2 group, 8.5% of the 25–30 kg/m2 group, and 9.5% of the >30 kg/m2 group (chi-square P value <0.001). In the multivariable logistic regression analysis, a change in BMI from 20 to 30 kg/m2 was associated with a reduced risk of in-hospital mortality (odds ratio: 0.39, 95% confidence interval: 0.23–0.67, P < 0.001).
Conclusion:
Our study results revealed that there was inverse significant association between BMI and in-hospital mortality in STEMI patients.
Get full access to this article
View all access options for this article.
References
1.
KristensenSD, LautKG, FajadetJ, et al.Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: Current status in 37 ESC countries. Eur Heart J, 2014; 35:1957–1970.
2.
IbanezB, JamesS, AgewallS, et al.2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J, 2018; 39:119–177.
3.
ShaoC, WangJ, LiP, et al.Evaluation of a risk index for predicting short-term and long-term outcomes in patients with ST-elevation myocardial infarction. Catheter Cardiovasc Interv, 2020; 95Suppl 1:542–549.
4.
ParsanathanR, JainS. Novel invasive and noninvasive cardiac-specific biomarkers in obesity and cardiovascular diseases. Metab Syndr Relat Disord, 2020; 18:10–30.
5.
KattaN, LoethenT, LavieC, et al.Obesity and coronary heart disease: Epidemiology, pathology, and coronary artery imaging. Curr Probl Cardiol, 2021; 46:100655.
6.
AlshammaryF, AlharbiK, AlshehriJ, et al.Metabolic syndrome and coronary artery disease risk: A meta-analysis of observational studies. Int J Environ Res Public Health, 2021; 18:1773.
7.
National Cholesterol Education Program (NCEP) Expert Panel onDetection, Evaluation and Treatment of High Blood Cholesterol inAdults. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 2002; 106:3143–3421.
8.
AngerasO, AlbertssonP, KarasonK, et al.Evidence for obesity paradox in patients with acute coronary syndromes: A report from the Swedish Coronary Angiography and Angioplasty Registry. Eur Heart J, 2013; 34:345–353.
9.
MadalaMC, FranklinBA, ChenAY, et al.Obesity and age of first non-ST-segment elevation myocardial infarction. J Am Coll Cardiol, 2008; 52:979–985.
10.
BalayahZ, Alsheikh-AliA, RashedW, et al.Association of obesity indices with in-hospital and 1-year mortality following acute coronary syndrome. Int J Obes(Lond), 2021; 45:358–368.
11.
AlbertiKG, EckelRH, GrundySM, et al.Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 2009; 120:1640–1645.
12.
BovoliniA, GarciaJ, AndradeA, et al.Metabolic syndrome pathophysiology and predisposing factors. Int J Sports Med, 2021; 42:199–214.
13.
KaurJ. A comprehensive review on metabolic syndrome. Cardiol Res Pract, 2014; 2014:943162.
14.
LavieCJ, De SchutterA, PatelD, et al.Body composition and coronary heart disease mortality—An obesity or a lean paradox?. Mayo Clin Proc, 2011; 86:857–864.
15.
LavieCJ, MilaniRV, VenturaHO. Obesity and cardiovascular disease: Risk factor, paradox, and impact of weight loss. J Am Coll Cardiol, 2009; 53:1925–1932.
16.
OreopoulosA, McAlisterFA, Kalantar-ZadehK, et al.The relationship between body mass index, treatment, and mortality in patients with established coronary artery disease: A report from APPROACH. Eur Heart J, 2009; 30:2584–2592.
17.
WuPJ, WangHT, SungPH, et al.No correlation between body mass index and 30-day prognostic outcome in Asians with acute ST-elevation myocardial infarction undergoing primary coronary intervention. Biomed J, 2017; 40:169–177.
18.
Elbaz-GreenerG, RozenG, CarassoS, et al.The relationship between body mass index and in-hospital mortality in the contemporary era of an acute myocardial infarction management. Vasc Health Risk Manag, 2021; 17:551–559.
19.
DasSR, AlexanderKP, ChenAY, et al.Impact of body weight and extreme obesity on the presentation, treatment, and in-hospital outcomes of 50,149 patients with ST-Segment elevation myocardial infarction results from the NCDR (National Cardiovascular Data Registry). J Am Coll Cardiol, 2011; 58:2642–2650.
20.
DhootJ, TariqS, ErandeA, et al.Effect of morbid obesity on in-hospital mortality and coronary revascularization outcomes after acute myocardial infarction in the United States. Am J Cardiol, 2013; 111:1104–1110.
21.
AdabagS, HuxleyRR, LopezFL, et al.Obesity related risk of sudden cardiac death in the Atherosclerosis Risk in Communities study. Heart, 2015; 101:215–221.
22.
AuneD, SchlesingerS, NoratT, et al.Body mass index, abdominal fatness, and the risk of sudden cardiac death: A systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol, 2018; 33:711–722.
23.
ChoyB, HansenE, MossAJ, et al.Relation of body mass index to sudden cardiac death and the benefit of implantable cardioverter-defibrillator in patients with left ventricular dysfunction after healing of myocardial infarction. Am J Cardiol, 2010; 105:581–586.
24.
AronsonD, NassarM, GoldbergT, et al.The impact of body mass index on clinical outcomes after acute myocardial infarction. Int J Cardiol, 2010; 145:476–480.
25.
NiedzielaJ, HudzikB, NiedzielaN, et al.The obesity paradox in acute coronary syndrome: A meta-analysis. Eur J Epidemiol, 2014; 29:801–812.
26.
WitassekF, SchwenkglenksM, ErneP, et al.Impact of Body Mass Index on mortality in Swiss hospital patients with ST-elevation myocardial infarction: Does an obesity paradox exist?. Swiss Med Wkly, 2014; 144:w13986.
27.
BucholzEM, KrumholzHA, KrumholzHM. Underweight, markers of cachexia, and mortality in acute myocardial infarction: A prospective cohort study of elderly medicare beneficiaries. PLoS Med, 2016; 13:e1001998.
