1. Untangling the obesity paradox in patients with acute myocardial infarction after primary percutaneous coronary intervention (detail analysis by age)
- Author
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Shusuke Fukuoka, Yasuhiro Saito, Katsutoshi Makino, Tetsuya Seko, Masaaki Ito, Jun Masuda, Kaoru Dohi, Hitoshi Kakimoto, Tairo Kurita, and Takashi Tanigawa
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Body Mass Index ,03 medical and health sciences ,Age Distribution ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Japan ,Risk Factors ,Cause of Death ,Internal medicine ,medicine ,Humans ,Obesity ,Prospective Studies ,Registries ,030212 general & internal medicine ,Myocardial infarction ,Survival analysis ,Aged ,business.industry ,Age Factors ,Percutaneous coronary intervention ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Conventional PCI ,Female ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Obesity paradox ,Follow-Up Studies - Abstract
Obesity is associated with increased morbidity and mortality. However, obesity paradox has been discussed in some patients with cardiovascular disease.We investigated the mechanisms of the obesity paradox in acute myocardial infarction (AMI) patients.We evaluated 1634 AMI patients with primary percutaneous coronary intervention (PCI). Patients were divided into 6 subgroups according to baseline body mass index (BMI) (low BMI:20 kg/mDuring the follow-up periods (median, 620 days; range, 344 to 730 days), 8.7% of patients experienced all-cause death. According to the Kaplan-Meier survival analysis, the patients in the younger age group with high BMI demonstrated significantly higher all-cause mortality compared to the other patients in the same age group (P = 0.012). In contrast, patients in the elderly age group with low BMI demonstrated significantly higher all-cause mortality compared to the others in the same age group (P 0.001). Multivariate cox regression analyses showed that low BMI in the elderly age group (HR 1.69, 95% CI 1.12 to 2.55, P = 0.012) and high BMI in the younger age group (HR 2.77, 95% CI 1.19 to 6.45, P = 0.018) were independent predictors of all-cause mortality.The obesity paradox was recognized only in patients in the elderly age group and not in the younger age group. The prognostic impact of BMI may differ by age in AMI patients.
- Published
- 2019