Hiroaki Yokoyama1, Hirofumi Tomita1, Satoshi Honda2, Kensaku Nishihira3, Sunao Kojima4, Misa Takegami5, Yasuhide Asaumi2, Jun Yamashita6, Mike Saji7, Masami Kosuge8, Jun Takahashi9, Yasuhiko Sakata2, Morimasa Takayama7, Tetsuya Sumiyoshi7, Hisao Ogawa10, Kazuo Kimura8, Satoshi Yasuda9. 1. Department of Cardiology and Nephrology, Hirosaki University Graduate School of Medicine. 2. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center. 3. Department of Cardiology, Miyazaki Medical Association Hospital. 4. Department of General Internal Medicine 3, Kawasaki Medical School. 5. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center. 6. Department of Cardiology, Tokyo Medical University Hospital. 7. Department of Cardiology, Sakakibara Heart Institute. 8. Division of Cardiology, Yokohama City University Medical Center. 9. Department of Cardiovascular Medicine, Tohoku University. 10. Kumamoto University.
Abstract
BACKGROUND: Acute myocardial infarction (AMI) patients with low body mass index (BMI) exhibit worse clinical outcomes than obese patients; however, to our knowledge, no prospective, nationwide study has assessed the effect of BMI on the clinical outcomes of AMI patients.Methods and Results: In this multi-center, prospective, nationwide Japanese trial, 2,373 AMI patients who underwent emergent percutaneous coronary intervention within 12 h of onset from the Japanese AMI Registry (JAMIR) were identified. Patients were divided into the following 4 groups based on their BMI at admission: Q1 group (BMI <18.5 kg/m2, n=133), Q2 group (18.5≤BMI<25.0 kg/m2, n=1,424), Q3 group (25.0≤BMI<30.0 kg/m2, n=672), and Q4 group (30.0 kg/m2≤BMI, n=144). The primary endpoint was all-cause death, and the secondary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction (MI), and non-fatal stroke. The median follow-up period was 358 days. Q1 patients were older and had lower prevalence of coronary risk factors. Q1 patients also had higher all-cause mortality and higher incidence of secondary endpoints than normal-weight or obese AMI patients. Multivariate analysis showed that low BMI (Q1 group) was an independent predictor for primary endpoint. CONCLUSIONS: AMI patients with low BMI had fewer coronary risk factors but worse clinical outcomes than normal-weight or obese patients.
BACKGROUND: Acute myocardial infarction (AMI) patients with low body mass index (BMI) exhibit worse clinical outcomes than obese patients; however, to our knowledge, no prospective, nationwide study has assessed the effect of BMI on the clinical outcomes of AMI patients.Methods and Results: In this multi-center, prospective, nationwide Japanese trial, 2,373 AMI patients who underwent emergent percutaneous coronary intervention within 12 h of onset from the Japanese AMI Registry (JAMIR) were identified. Patients were divided into the following 4 groups based on their BMI at admission: Q1 group (BMI <18.5 kg/m2, n=133), Q2 group (18.5≤BMI<25.0 kg/m2, n=1,424), Q3 group (25.0≤BMI<30.0 kg/m2, n=672), and Q4 group (30.0 kg/m2≤BMI, n=144). The primary endpoint was all-cause death, and the secondary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction (MI), and non-fatal stroke. The median follow-up period was 358 days. Q1 patients were older and had lower prevalence of coronary risk factors. Q1 patients also had higher all-cause mortality and higher incidence of secondary endpoints than normal-weight or obese AMI patients. Multivariate analysis showed that low BMI (Q1 group) was an independent predictor for primary endpoint. CONCLUSIONS: AMI patients with low BMI had fewer coronary risk factors but worse clinical outcomes than normal-weight or obese patients.
Entities:
Keywords:
Acute myocardial infarction; Coronary risk factors; Low body mass index; Obesity paradox