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We assessed the ability of predicting mortality and total in-hospital bleeding and adverse outcomes by the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). A total of 1441 STEMI patients were recruited: HBR group 354 (25%) patients and non-HBR group of 1087 (75%) patients. A total of 131 patients (9%) had a bleeding complication during hospitalization. The bleeding complications were also categorized according to other conventional bleeding scores. According to these conventional scores, all bleeding categories were associated with HBR. In univariate logistic regression analysis, female gender, diabetes mellitus, hypertension (HT) and HBR were associated with in-hospital bleeding. However, in multivariable analysis only HT (Odds Ratio [OR] 1.528, 95% CI 1.020-2.290; P = .040) and HBR (OR 1.612, 95% CI 1.075-2.428; P = .022) independently predicted total in-hospital bleeding complications. Hospital duration was longer and mortality rate was significantly higher in patients with HBR (OR 8.755, 95% CI 5.864-13.074; P < .01). The ARC-HBR criteria may predict in-hospital bleeding events and adverse outcomes in STEMI patients undergoing pPCI., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Obesity is a global health problem that increases the risk of coronary artery disease (CAD). However in studies, it has been observed that when the disease develops, obese patients have a more favorable prognosis than leaner patients. This is called the "obesity paradox." This study aims to evaluate the effect of obesity assessed with body fat percentage (BFP) and relative fat mass (RFM) besides body mass index (BMI) on infarct size (IS) estimated from peak creatine kinase-MB (CK-MB) levels in patients with non-ST-segment elevation myocardial infarction (NSTEMI)., Methods: Patients with a diagnosis of NSTEMI who underwent coronary angiography between January 2017 and January 2022 were retrospectively evaluated. Patients without available anthropometric data to calculate BMI, BFP, and RFM and serial CK-MB measurements were excluded from the study. BMI was calculated using weight(kg)/(height[m]) 2 formula. Patients were dichotomized as obese (BMI≥30 kg/m 2 ) and non-obese (BMI<30 kg/m 2 ) to compare baseline characteristics. BFP and RFM were calculated from anthropometric data. Linear regression analysis was performed to define predictors of IS., Results: Final study population consisted of 748 NSTEMI patients (mean age was 59.3±11.2 years, 76.3% were men, 36.1% of the patients were obese). Obese patients were more likely to be female, hypertensive, and diabetic. Smoking was less frequently observed in obese patients. Peak CK-MB levels were similar among groups. Obese patients had higher in-hospital left ventricular ejection fraction, and less severe CAD was observed in coronary angiographies of these patients. Multivariable regression analysis identified diabetes mellitus, systolic blood pressure, white blood cell count, hemoglobin, and BFP (β=-4.8, 95% CI=-8.7; -0.3, p=0.03) as independent predictors of IS., Conclusion: Higher BFP is associated with smaller IS in NSTEMI patients. These findings support the obesity paradox in this patient group, but further, randomized controlled studies are required., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2023 by Istanbul Provincial Directorate of Health.)

Objectives: 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/m 2 . Considering the in-hospital mortality frequencies between the groups, mortality was observed in 61.7% of the BMI <20 kg/m 2 group, 15.5% of the 20-25 kg/m 2 group, 8.5% of the 25-30 kg/m 2 group, and 9.5% of the >30 kg/m 2 group (chi-square P value <0.001). In the multivariable logistic regression analysis, a change in BMI from 20 to 30 kg/m 2 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.