'Obesity Paradox' in Myocardial Infarction Patients.
- Author:
Sukwon HAHN
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Body mass index;
Obesity;
Death;
Angioplasty
- MeSH:
Angioplasty;
Body Mass Index;
Cholesterol;
Heart Ventricles;
Humans;
Lipoproteins;
Logistic Models;
Myocardial Infarction*;
Obesity;
Overweight;
Percutaneous Coronary Intervention;
Prognosis;
Risk Factors
- From:Korean Journal of Health Promotion
2012;12(2):83-89
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Despite the adverse impact that being overweight or obese has on cardiovascular disorders, numerous studies have addressed the 'obesity paradox', which suggests that obese persons seem to have a better prognosis with these conditions than those with a normal body mass index (BMI). In addition, the effect of BMI on outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) remains controversial. METHODS: Our subjects included 457 patients who had undergone PCI for AMI between January 1, 2009 and September 30, 2011. They were classified into 3 groups according to baseline BMI - normal weight (BMI<23 kg/m2), overweight (BMI 23-25 kg/m2), obesity (BMI>25 kg/m2). Clinical characteristic and cardiovascular risk factors and major adverse cardiac events (MACE), including death after PCI, were compared among the groups. RESULTS: Overweight or obese subjects were younger (P<0.001) and associated with higher left ventricle ejection fraction (LVEF) (P=0.012) and less frequency of MACE (P=0.003). Multiple logistic regression analysis showed that independent predictors for death and MACE were not obesity but age (P=0.006, P=0.017), high-density lipoprotein cholesterol (P=0.002, P=0.005) and LVEF (P=0.001, P<0.001). CONCLUSIONS: In our study, BMI had no effect on MACE in patients undergoing primary PCI for AMI. The phenomenon, 'obesity paradox', may be explained by the possibility that AMI was diagnosed at a younger age in obese patients and that these younger patients had higher LVEFs than the other groups in this study.
