Is increased body mass index associated with a cardioprotective effect after ST-segment-elevation myocardial infarction?

Recent studies highlighted the 'obesity paradox' after revascularization, suggesting a 'cardioprotective' effect of obesity. We assessed the association of BMI and regional wall motion score (RWMS) and peak CK and cTnI values (markers of infarct size) and 30-day survival among consecutive first ST-segment-elevation myocardial infarction patients who underwent successful primary PCI. Of the 164 patients, we found no difference in infarct size among the different groups, BMI < or = 25 kg/m2, 25 < BMI < or = 30 kg/m2, and BMI > 30 kg/m2, and no association between BMI as continuous variable and these variables. Thirty-day death rates were not statistically different among the three groups (10, 5, 2%, respectively, P = 0.83). Increased BMI does not confer any protective effect on the heart during acute ischemia.