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KMID : 0928320120120020083
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Korean Journal of Health Promotion and Disease Prevention
2012 Volume.12 No. 2 p.83 ~ p.89
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‘Obesity Paradox’ in Myocardial Infarction Patients
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Han Suk-Won
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Abstract
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Background: Despite the adverse impact that being overweight or obese has on cardiovascular disorders, numerous studies have addressed the ‘obesity paradox’, which suggests that obese persons seem to have a better prognosis with these conditions than those with a normal body mass index (BMI). In addition, the effect of BMI on outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) remains controversial.
Methods: Our subjects included 457 patients who had undergone PCI for AMI between January 1, 2009 and September 30, 2011. They were classified into 3 groups according to baseline BMI - normal weight (BMI<23 kg/m2), overweight (BMI 23-25 kg/m2), obesity (BMI>25 kg/m2). Clinical characteristic and cardiovascular risk factors and major adverse cardiac events (MACE), including death after PCI, were compared among the groups.
Results: Overweight or obese subjects were younger (P<0.001) and associated with higher left ventricle ejection fraction (LVEF) (P=0.012) and less frequency of MACE (P=0.003). Multiple logistic regression analysis showed that independent predictors for death and MACE were not obesity but age (P=0.006, P=0.017), high-density lipoprotein cholesterol (P=0.002, P=0.005) and LVEF (P=0.001, P<0.001).
Conclusions: In our study, BMI had no effect on MACE in patients undergoing primary PCI for AMI. The phenomenon, ’obesity paradox’, may be explained by the possibility that AMI was diagnosed at a younger age in obese patients and that these younger patients had higher LVEFs than the other groups in this study.
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KEYWORD
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Myocardial infarction, Body mass index, Obesity, Death, Angioplasty
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