PMID- 31109890
OWN - NLM
STAT- MEDLINE
DCOM- 20201126
LR  - 20201126
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 29
IP  - 3
DP  - 2020 Mar
TI  - Influence of BMI on Short and Long-Term Outcomes in Patients With STEMI and LV 
      Dysfunction.
PG  - 361-367
LID - S1443-9506(19)30295-1 [pii]
LID - 10.1016/j.hlc.2019.01.017 [doi]
AB  - BACKGROUND: Recent studies suggest an obesity paradox in individuals with 
      myocardial infarction with better outcomes in obese relative to normal weight 
      patients. We assessed the influence of body mass index (BMI) on early and 
      long-term outcomes in patients with ST elevation myocardial infarction (STEMI) 
      and left ventricular (LV) dysfunction. METHODS: Outcomes were assessed according 
      to BMI status in 478 consecutive patients with STEMI and LV dysfunction (ejection 
      fraction [EF]<40%) admitted to Westmead Hospital between 1 January 2004 and 16 
      April 2014. Normal weight, overweight and obesity were defined as BMI < 25, 
      25-29.9, and >/=30 kg/m2, respectively. RESULTS: Obese patients were significantly 
      younger (p = 0.01) and were more likely to have hypertension and diabetes 
      (p = 0.04 and 0.001 respectively). In hospital outcomes and 30-day major adverse 
      cardiac events (MACE) were similar in all three groups. There was no difference 
      in recurrent myocardial infarction (MI) and target vessel revascularisation (TVR) 
      during long-term follow-up (mean follow-up 809 days). Overall mortality following 
      hospital discharge was significantly lower in overweight and obese patients. 
      Adjusted hazard ratio for all-cause mortality in normal weight patients compared 
      to overweight patients was 2.4 (95% C.I 1.1-5.3, p= -0.03). The adjusted hazard 
      ratio for all-cause mortality in normal weight patients in comparison to obese 
      patients was 2.7 (95% C.I, 1 -7.4, p = 0.05). Left ventricular ejection fraction 
      (LVEF) and age were other predictors of all-cause mortality. CONCLUSIONS: Normal 
      weight, overweight and obese patients with STEMI and LV dysfunction had similar 
      in hospital outcomes and 30-day outcomes. Long-term all-cause mortality was, 
      however, higher in normal weight patients suggesting the presence of an obesity 
      paradox in this cohort.
CI  - Copyright (c) 2019. Published by Elsevier B.V.
FAU - Samanta, Rahul
AU  - Samanta R
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; The 
      University of Sydney, Sydney, NSW, Australia.
FAU - Narayan, Arun
AU  - Narayan A
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
FAU - Kovoor, Pramesh
AU  - Kovoor P
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; The 
      University of Sydney, Sydney, NSW, Australia.
FAU - Thiagalingam, Aravinda
AU  - Thiagalingam A
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; The 
      University of Sydney, Sydney, NSW, Australia. Electronic address: 
      arravinda.thiagalingam@sydney.edu.au.
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
DEP - 20190403
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Aged
MH  - *Body Mass Index
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Obesity/mortality/pathology/physiopathology/therapy
MH  - *ST Elevation Myocardial Infarction/mortality/pathology/physiopathology/therapy
MH  - Survival Rate
MH  - *Ventricular Dysfunction, Left/mortality/pathology/physiopathology/therapy
OTO - NOTNLM
OT  - Ischaemic cardiomyopathy
OT  - Obesity
OT  - Obesity Paradox
OT  - STEMI
EDAT- 2019/05/22 06:00
MHDA- 2020/11/27 06:00
CRDT- 2019/05/22 06:00
PHST- 2018/10/19 00:00 [received]
PHST- 2019/01/06 00:00 [revised]
PHST- 2019/01/27 00:00 [accepted]
PHST- 2019/05/22 06:00 [pubmed]
PHST- 2020/11/27 06:00 [medline]
PHST- 2019/05/22 06:00 [entrez]
AID - S1443-9506(19)30295-1 [pii]
AID - 10.1016/j.hlc.2019.01.017 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2020 Mar;29(3):361-367. doi: 10.1016/j.hlc.2019.01.017. Epub 
      2019 Apr 3.