Vol 70, No 7 (2012)
Original articles
Published online: 2012-07-18

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Do overweight patients have a better five years prognosis after an acute myocardial infarction treated with coronary intervention?

Anna Tomaszuk−Kazberuk, Marcin Kożuch, Jolanta Małyszko, Hanna Bachórzewska−Gajewska, Urszula Kosacka, Sławomir Dobrzycki, Włodzimierz J. Musiał
DOI: 10.33963/v.kp.78864
Kardiol Pol 2012;70(7):686-693.

Abstract

Background: Obesity and overweight alone may confer a survival benefit after myocardial infarction, independent of age, medical care or therapy.

Aim: To evaluate the impact of body mass index (BMI) on long-term mortality in ST-segment elevation acute myocardial infarction (STEMI) patients treated by primary angioplasty (PCI).

Methods: We prospectively studied a homogenous group of 131 patients who had suffered STEMI, and subsequently exhibited a TIMI 3 flow after primary PCI. The patients (41 women, 90 men, mean age 58.3 ± 10.8 years) were analysed in two groups: Group 1 — 30 (23%) patients with BMI < 25 kg/m2 and Group 2 — 101 (77%) patients with BMI ≥ 25 kg/m2.

Results: Altogether, 19 (14.5%) patients died during the five-year follow-up period — nine out of 30 (30%) were patients with BMI < 25 kg/m2, and ten out of 101 (10%) were patients with BMI ≥ 25 kg/m2 (p < 0.001). Individuals with BMI ≥ 25 kg/m2 had lower five-year mortality, and this was independent of other potentially confounding variables. Area under the receiveroperating characteristic (ROC) curves for death with respect to weight on ROC analysis was significantly different than for a random model (p < 0.05). There were no significant differences in 30-day mortality and one-year mortality (p = 0.6517 and p = 0.3573, respectively).

Conclusions: Patients after primary angioplasty for STEMI with BMI < 25 kg/m2 and patients with BMI ≥ 25 kg/m2 have no difference in 30-day or one-year mortality, but individuals with BMI ≥ 25 kg/m2 have a better five year prognosis, and this is independent of other potentially confounding variables.

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Polish Heart Journal (Kardiologia Polska)