PMID- 29885681
OWN - NLM
STAT- MEDLINE
DCOM- 20190114
LR  - 20190114
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 265
DP  - 2018 Aug 15
TI  - Influence of BMI on inducible ventricular tachycardia and mortality in patients 
      with myocardial infarction and left ventricular dysfunction: The obesity paradox.
PG  - 148-154
LID - S0167-5273(17)37857-9 [pii]
LID - 10.1016/j.ijcard.2018.03.055 [doi]
AB  - BACKGROUND: There is little known about the influence of obesity on ventricular 
      electrical remodelling after myocardial infarction. The aim of our study was to 
      assess the relationship between body mass index (BMI) and the primary outcome of 
      inducible-VT and the secondary outcome of all-cause mortality in consecutive 
      patients who presented with ST elevation myocardial infarction (STEMI) and 
      LV-dysfunction (LVEF </= 40%). METHODS AND RESULTS: Consecutive patients (n = 380) 
      with STEMI and LV-dysfunction (LVEF </= 40%) underwent electrophysiological (EP) 
      studies for risk-stratification. Inducible-VT >/=200 ms cycle-length (CL) with one 
      to four extra-stimuli (ES) was considered abnormal. Patients were classified 
      according their body mass index (BMI) to be normal (18.5-24.9), overweight 
      (25-29.9) or obese (>30). The primary outcome of inducible-VT occurred in 42.7%, 
      21.5% and 21% of normal weight, overweight and obese patients respectively 
      (p < 0.001). When adjusting for ejection-fraction, hypertension and 
      triple-vessel-disease, normal BMI remained a significant predictor for 
      inducible-VT. All-cause mortality was higher in patients with normal weight 
      (12.8%) when compared to overweight (3.2%) and obese (3.8%) patients (p = 0.002) 
      and was mainly driven by increased cardiac-death (6.8%, 1.9% and 1.9% in normal, 
      overweight and obese patients respectively, p = 0.05). After adjusting for age, 
      EF, and hypertension, normal BMI remained a significant predictor of mortality. 
      CONCLUSION: In patients presenting with STEMI and LV-dysfunction, BMI appears to 
      be a significant predictor of inducible-VT and all-cause mortality, with worse 
      outcomes for those with normal weight, when compared to overweight or obese 
      individuals. These findings are consistent with the obesity-paradox.
CI  - Copyright (c) 2018. Published by Elsevier B.V.
FAU - Samanta, Rahul
AU  - Samanta R
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia; The University of 
      Sydney, Sydney, Australia.
FAU - Pouliopoulos, Jim
AU  - Pouliopoulos J
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia; The University of 
      Sydney, Sydney, Australia.
FAU - Kumar, Saurabh
AU  - Kumar S
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia.
FAU - Narayan, Arun
AU  - Narayan A
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia.
FAU - Nadri, Fazlur
AU  - Nadri F
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia.
FAU - Qian, Pierre
AU  - Qian P
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia.
FAU - Thomas, Stuart
AU  - Thomas S
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia; The University of 
      Sydney, Sydney, Australia.
FAU - Sivagangabalan, Gopal
AU  - Sivagangabalan G
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia.
FAU - Kovoor, Pramesh
AU  - Kovoor P
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia; The University of 
      Sydney, Sydney, Australia.
FAU - Thiagalingam, Aravinda
AU  - Thiagalingam A
AD  - Department of Cardiology, Westmead Hospital, Sydney, Australia; The University of 
      Sydney, Sydney, Australia. Electronic address: 
      aravinda.thiagalingam@sydney.edu.au.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
CIN - Int J Cardiol. 2018 Aug 15;265:169-170. PMID: 29885682
MH  - Adult
MH  - Aged
MH  - *Body Mass Index
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/epidemiology/*physiopathology
MH  - Obesity/diagnosis/epidemiology/*physiopathology
MH  - Risk Factors
MH  - Single-Blind Method
MH  - Tachycardia, Ventricular/diagnosis/epidemiology/*physiopathology
MH  - Ventricular Dysfunction, Left/diagnosis/epidemiology/*physiopathology
OTO - NOTNLM
OT  - Electrophysiology
OT  - Myocardial infarction
OT  - Obesity
OT  - Ventricular arrhythmia
EDAT- 2018/06/11 06:00
MHDA- 2019/01/15 06:00
CRDT- 2018/06/11 06:00
PHST- 2017/12/22 00:00 [received]
PHST- 2018/03/05 00:00 [revised]
PHST- 2018/03/12 00:00 [accepted]
PHST- 2018/06/11 06:00 [entrez]
PHST- 2018/06/11 06:00 [pubmed]
PHST- 2019/01/15 06:00 [medline]
AID - S0167-5273(17)37857-9 [pii]
AID - 10.1016/j.ijcard.2018.03.055 [doi]
PST - ppublish
SO  - Int J Cardiol. 2018 Aug 15;265:148-154. doi: 10.1016/j.ijcard.2018.03.055.