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Clinical Implication of 'Obesity Paradox' in Elderly Patients With Acute Myocardial Infarction

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Author(s)
Hun-Tae KimSung-Yun JungJong-Ho NamJung-Hee LeeChan-Hee LeeJang-Won SonUng KimJong-Seon ParkDong-Gu ShinSung-Ho HerKi-yuk ChangTae-Hoon AhnMyung-Ho JeongSeung-Woon RhaHyo-Soo KimHyeon-Cheol GwonIn-Whan SeongKyung-Kuk HwangSung-Chull ChaeKwon-Bae KimKwang-Soo ChaSeok-Kyu OhJei-Keon ChaeKAMIR-NIH registry investigators
Keimyung Author(s)
Kim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Heart, lung & circulation
Issued Date
2021
Volume
30
Issue
4
Keyword
Myocardial infarctionAges 80≥yearsBody mass indexCardiovascular outcome
Abstract
Background:
The clinical impact of body mass index (BMI), especially in the elderly with acute myocardial infarction (AMI), has not been sufficiently evaluated. The purpose of this study was to elucidate the clinical impact of BMI in very old patients (≥80 years) with AMI.

Methods:
The study analysed 2,489 AMI patients aged ≥80 years from the Korea Acute Myocardial Infarction Registry and the Korea Working Group on Myocardial Infarction (KAMIR/KorMI) registries between November 2005 and March 2012. The study population was categorised into four groups based on their BMI: underweight (n=301), normal weight (n=1,150), overweight (n=890), and obese (n=148). The primary endpoint was major adverse cardiovascular event (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularisation, and target vessel revascularisation.

Results:
Baseline characteristics among the four groups were similar, except for hypertension (45.1 vs 58.4 vs 66.2 vs 69.9%, respectively; p<0.001) and diabetes (16.6 vs 23.6 vs 30.7 vs 35.1%, respectively; p<0.001). Coronary care unit length of stay was significantly different among the four groups during hospitalisation (5.3±5.9 vs 4.8±6.8 vs 4.2±4.0 vs 3.5±2.1 days; p=0.007). MACE (16.9 vs 14.9 vs 13.7 vs 8.8%; p=0.115) and cardiac death (10.3 vs 8.4 vs 7.9 vs 4.1%; p=0.043) less frequently occurred in the obese group than in other groups during the 1-year follow-up. A multivariate regression model showed obese status (BMI ≥27.5 kg/m2) as an independent predictor of reduced MACE (hazard ratio [HR], 0.20; 95% confidence interval [CI], 0.06-0.69; p=0.010) along with reduced left ventricular ejection fraction (≤40%) as a predictor of increased MACE (HR,1.87; 95% CI, 1.31-2.68; p=0.001).

Conclusion:
Body mass index in elderly patients with acute myocardial infarction was significantly associated with coronary care unit stay and clinical cardiovascular outcomes.
Keimyung Author(s)(Kor)
김권배
Publisher
School of Medicine (의과대학)
Citation
Hun-Tae Kim et al. (2021). Clinical Implication of “Obesity Paradox” in Elderly Patients With Acute Myocardial Infarction. Heart, lung & circulation, 30(4), 481–488. doi: 10.1016/j.hlc.2020.08.013
Type
Article
ISSN
1444-2892
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1443950620304480
DOI
10.1016/j.hlc.2020.08.013
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43086
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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