Hun-Tae Kim1, Sung-Yun Jung2, Jong-Ho Nam1, Jung-Hee Lee1, Chan-Hee Lee1, Jang-Won Son1, Ung Kim3, Jong-Seon Park1, Dong-Gu Shin1, Sung-Ho Her4, Ki-Yuk Chang5, Tae-Hoon Ahn6, Myung-Ho Jeong7, Seung-Woon Rha8, Hyo-Soo Kim9, Hyeon-Cheol Gwon10, In-Whan Seong11, Kyung-Kuk Hwang12, Sung-Chull Chae13, Kwon-Bae Kim14, Kwang-Soo Cha15, Seok-Kyu Oh16, Jei-Keon Chae17. 1. Division of Cardiology, Yeungnam University Medical Center, Daegu, Republic of Korea. 2. Division of Cardiology, Dongkang Medical Center, Ulsan, Republic of Korea. 3. Division of Cardiology, Yeungnam University Medical Center, Daegu, Republic of Korea. Electronic address: woongwa@yu.ac.kr. 4. The Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, Republic of Korea. 5. The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea. 6. Gachon University, Gil Medical Center, Incheon, Republic of Korea. 7. Chonnam National University Hospital, Gwangju, Republic of Korea. 8. Korea University, Guro Hospital, Seoul, Republic of Korea. 9. Seoul National University Hospital, Seoul, Republic of Korea. 10. Sungkyunkwan Universtiy, Samsung Medical Center, Seoul, Republic of Korea. 11. Chungnam National University Hospital, Daejeon, Republic of Korea. 12. Chungbuk National University Hospital, Cheongju, Republic of Korea. 13. Kyungpook National University Hospital, Daegu, Republic of Korea. 14. Keimyung University Dongsan Medical Center, Daegu, Republic of Korea. 15. Pusan National University Hospital, Busan, Republic of Korea. 16. Wonkwang University Hospital, Iksan, Republic of Korea. 17. Chonbuk National University Hospital, Jeonju, Republic of Korea.
Abstract
BACKGROUND: The clinical impact of body mass index (BMI), especially in the elderly with acute myocardial infarction (AMI), has not been sufficiently evaluated. The purpose of this study was to elucidate the clinical impact of BMI in very old patients (≥80 years) with AMI. METHODS: The study analysed 2,489 AMI patients aged ≥80 years from the Korea Acute Myocardial Infarction Registry and the Korea Working Group on Myocardial Infarction (KAMIR/KorMI) registries between November 2005 and March 2012. The study population was categorised into four groups based on their BMI: underweight (n=301), normal weight (n=1,150), overweight (n=890), and obese (n=148). The primary endpoint was major adverse cardiovascular event (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularisation, and target vessel revascularisation. RESULTS: Baseline characteristics among the four groups were similar, except for hypertension (45.1 vs 58.4 vs 66.2 vs 69.9%, respectively; p<0.001) and diabetes (16.6 vs 23.6 vs 30.7 vs 35.1%, respectively; p<0.001). Coronary care unit length of stay was significantly different among the four groups during hospitalisation (5.3±5.9 vs 4.8±6.8 vs 4.2±4.0 vs 3.5±2.1 days; p=0.007). MACE (16.9 vs 14.9 vs 13.7 vs 8.8%; p=0.115) and cardiac death (10.3 vs 8.4 vs 7.9 vs 4.1%; p=0.043) less frequently occurred in the obese group than in other groups during the 1-year follow-up. A multivariate regression model showed obese status (BMI ≥27.5 kg/m2) as an independent predictor of reduced MACE (hazard ratio [HR], 0.20; 95% confidence interval [CI], 0.06-0.69; p=0.010) along with reduced left ventricular ejection fraction (≤40%) as a predictor of increased MACE (HR,1.87; 95% CI, 1.31-2.68; p=0.001). CONCLUSION: Body mass index in elderly patients with acute myocardial infarction was significantly associated with coronary care unit stay and clinical cardiovascular outcomes.
BACKGROUND: The clinical impact of body mass index (BMI), especially in the elderly with acute myocardial infarction (AMI), has not been sufficiently evaluated. The purpose of this study was to elucidate the clinical impact of BMI in very old patients (≥80 years) with AMI. METHODS: The study analysed 2,489 AMI patients aged ≥80 years from the Korea Acute Myocardial Infarction Registry and the Korea Working Group on Myocardial Infarction (KAMIR/KorMI) registries between November 2005 and March 2012. The study population was categorised into four groups based on their BMI: underweight (n=301), normal weight (n=1,150), overweight (n=890), and obese (n=148). The primary endpoint was major adverse cardiovascular event (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularisation, and target vessel revascularisation. RESULTS: Baseline characteristics among the four groups were similar, except for hypertension (45.1 vs 58.4 vs 66.2 vs 69.9%, respectively; p<0.001) and diabetes (16.6 vs 23.6 vs 30.7 vs 35.1%, respectively; p<0.001). Coronary care unit length of stay was significantly different among the four groups during hospitalisation (5.3±5.9 vs 4.8±6.8 vs 4.2±4.0 vs 3.5±2.1 days; p=0.007). MACE (16.9 vs 14.9 vs 13.7 vs 8.8%; p=0.115) and cardiac death (10.3 vs 8.4 vs 7.9 vs 4.1%; p=0.043) less frequently occurred in the obese group than in other groups during the 1-year follow-up. A multivariate regression model showed obese status (BMI ≥27.5 kg/m2) as an independent predictor of reduced MACE (hazard ratio [HR], 0.20; 95% confidence interval [CI], 0.06-0.69; p=0.010) along with reduced left ventricular ejection fraction (≤40%) as a predictor of increased MACE (HR,1.87; 95% CI, 1.31-2.68; p=0.001). CONCLUSION: Body mass index in elderly patients with acute myocardial infarction was significantly associated with coronary care unit stay and clinical cardiovascular outcomes.
Authors: Ching-Hui Sia; Junsuk Ko; Huili Zheng; Andrew Fu-Wah Ho; David Foo; Ling-Li Foo; Patrick Zhan-Yun Lim; Boon Wah Liew; Ping Chai; Tiong-Cheng Yeo; James W L Yip; Terrance Chua; Mark Yan-Yee Chan; Jack Wei Chieh Tan; Gemma Figtree; Heerajnarain Bulluck; Derek J Hausenloy Journal: Front Cardiovasc Med Date: 2022-04-14
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