Gwan Hyeop Sohn1, Eun Kyoung Kim1, Joo-Yong Hahn2, Young Bin Song1, Jeong Hoon Yang3, Sung-A Chang4, Sang-Chol Lee4, Yeon Hyeon Choe5, Seung-Hyuk Choi1, Jin-Ho Choi6, Sang Hoon Lee1, Jae K Oh1, Hyeon-Cheol Gwon1. 1. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: jyhahn@skku.edu. 3. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 5. Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVE: Although obesity is a risk factor for cardiovascular disease and mortality, several studies have reported that patients with obesity who have suffered acute myocardial infarction or have undergone percutaneous coronary intervention (PCI) have better clinical outcomes than their normal weight counterparts. We evaluated the impact of overweight on myocardial infarct size in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: We performed contrast-enhanced magnetic resonance imaging on 193 patients undergoing primary PCI for STEMI. Infarct size was measured with delayed-enhancement imaging and the area at risk was quantified on T2-weighted images. RESULTS: Baseline characteristics and angiographic findings were not significantly different between the normal weight group (body mass index [BMI] < 25 kg/m(2), n = 110) and the overweight group (BMI ≥ 25 kg/m(2), n = 83). The median percent infarct volume and area at risk were significantly smaller in the overweight group than the normal weight group (17.9% [9.0-24.9%] vs. 20.8% [11.4-33.1%], p = 0.04 and 29.4% [20.5-37.6%] vs. 36.0% [25.7-49.6%], p < 0.01, respectively). However, the myocardial salvage index was not different between the 2 groups (overweight group vs. normal weight group, 43.2% vs. 39.2%, p = 0.69). BMI ≥ 25 kg/m(2) was an independent predictor of smaller infarct size in multivariate analysis (Odds ratio 0.51, 95% Confidence interval 0.27-0.97, p = 0.039). CONCLUSION: Overweight (BMI ≥ 25 kg/m(2)) is independently associated with smaller infarct size in patients undergoing primary PCI for STEMI.
OBJECTIVE: Although obesity is a risk factor for cardiovascular disease and mortality, several studies have reported that patients with obesity who have suffered acute myocardial infarction or have undergone percutaneous coronary intervention (PCI) have better clinical outcomes than their normal weight counterparts. We evaluated the impact of overweight on myocardial infarct size in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: We performed contrast-enhanced magnetic resonance imaging on 193 patients undergoing primary PCI for STEMI. Infarct size was measured with delayed-enhancement imaging and the area at risk was quantified on T2-weighted images. RESULTS: Baseline characteristics and angiographic findings were not significantly different between the normal weight group (body mass index [BMI] < 25 kg/m(2), n = 110) and the overweight group (BMI ≥ 25 kg/m(2), n = 83). The median percent infarct volume and area at risk were significantly smaller in the overweight group than the normal weight group (17.9% [9.0-24.9%] vs. 20.8% [11.4-33.1%], p = 0.04 and 29.4% [20.5-37.6%] vs. 36.0% [25.7-49.6%], p < 0.01, respectively). However, the myocardial salvage index was not different between the 2 groups (overweight group vs. normal weight group, 43.2% vs. 39.2%, p = 0.69). BMI ≥ 25 kg/m(2) was an independent predictor of smaller infarct size in multivariate analysis (Odds ratio 0.51, 95% Confidence interval 0.27-0.97, p = 0.039). CONCLUSION: Overweight (BMI ≥ 25 kg/m(2)) is independently associated with smaller infarct size in patients undergoing primary PCI for STEMI.