Comparison of 2-year mortality according to obesity in stabilized patients with type 2 diabetes mellitus after acute myocardial infarction: results from the DIAMOND prospective cohort registry
- Author(s)
- Ki‑Bum Won; Seung‑Ho Hur; Yun‑Kyeong Cho; Hyuck‑Jun Yoon; Chang‑Wook Nam; Kwon‑Bae Kim; Jang‑Ho Bae; Dong‑Ju Choi; Young‑Keun Ahn; Jong‑Seon Park; Hyo‑Soo Kim; Rak‑Kyeong Choi; Donghoon Choi; Joon‑Hong Kim; Kyoo‑Rok Han; Hun‑Sik Park; So‑Yeon Choi; Jung‑Han Yoon; Hyeon‑Cheol Kwon; Seung‑Un Rha; Kyung‑Kuk Hwang; Do‑Sun Lim; Kyung‑Tae Jung; Seok‑Kyu Oh; Jae‑Hwan Lee; Eun‑Seok Shin; Kee‑Sik Kim
- Keimyung Author(s)
- Hur, Seung Ho; Cho, Yun Kyeong; Yoon, Hyuck Jun; Nam, Chang Wook; Kim, Kwon Bae
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Cardiovascular Diabetology
- Issued Date
- 2015
- Volume
- 14
- Issue
- 141
- Keyword
- Type 2 diabetes mellitus; Acute myocardial infarction; Obesity; Survival
- Abstract
- Background: After acute myocardial infarction (AMI), the replicated phenomenon of obesity paradox, i.e., obesity
appearing to be associated with increased survival, has not been evaluated in stabilized (i.e., without clinical events
within 1 month post AMI) Asian patients with diabetes mellitus (DM).
Methods: Among 1192 patients in the DIabetic Acute Myocardial InfarctiON Disease (DIAMOND) Korean multicenter
registry between April 2010 and June 2012, 2-year cardiac and all-cause death were compared according to obesity
(body mass index ≥25 kg/m2) in 1125 stabilized DM patients.
Results: Compared with non-obese DM patients (62 % of AMI patients), obese DM patients had: higher incidence
of dyslipidemia (31 vs. 24 %, P < 0.01); lower incidence of chronic kidney disease (26 vs. 33 %) (P < 0.01); higher left
ventricular ejection fraction after AMI (53 ± 11 vs. 50 ± 12 %, P < 0.001); and lower 2-year cardiac and all-cause
death occurrence (0.7 vs. 3.6 % and 1.9 vs. 5.2 %, both P < 0.01) and cumulative incidence in Kaplan–Meier analysis
(P < 0.005, respectively). Likewise, both univariate and multivariate Cox hazard regression analyses adjusted for the
respective confounders showed that obesity was associated with decreased risk of both cardiac [HR, 0.18 (95 % CI
0.06–0.60), P = 0.005; and 0.24 (0.07–0.78), P = 0.018, respectively] and all-cause death [0.34 (0.16–0.73), P = 0.005;
and 0.44 (0.20–0.95), P = 0.038].
Conclusions: In a Korean population of stabilized DM patients after AMI, non-obese patients appear to have higher
cardiac and all-cause mortality compared with obese patients after adjusting for confounding factors.
Keywords: Type 2 diabetes mellitus, Acute myocardial infarction, Obesity, Survival
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