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

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-Woon Rha & 7 others Kyung Kuk Hwang, Do-Sun Lim, Kyung Tae Jung, Seok Kyu Oh, Jae Hwan Lee, Eun Seok Shin, Kee Sik Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Article number141
JournalCardiovascular Diabetology
Volume14
Issue number1
DOIs
Publication statusPublished - 2015 Oct 15

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Cardiomyopathies
Type 2 Diabetes Mellitus
Registries
Obesity
Myocardial Infarction
Mortality
Diabetes Mellitus
Cause of Death
Incidence
Kaplan-Meier Estimate
Dyslipidemias
Chronic Renal Insufficiency
Stroke Volume
Body Mass Index
Regression Analysis
Survival
Population

Keywords

  • Acute myocardial infarction
  • Obesity
  • Survival
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

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. / Won, Ki Bum; Hur, Seung Ho; Cho, Yun Kyeong; Yoon, Hyuck Jun; Nam, Chang Wook; Kim, Kwon Bae; Bae, Jang Ho; Choi, Dong Ju; Ahn, Young Keun; Park, Jong Seon; Kim, Hyo Soo; Choi, Rak Kyeong; Choi, Donghoon; Kim, Joon Hong; Han, Kyoo Rok; Park, Hun Sik; Choi, So Yeon; Yoon, Jung Han; Kwon, Hyeon Cheol; Rha, Seung-Woon; Hwang, Kyung Kuk; Lim, Do-Sun; Jung, Kyung Tae; Oh, Seok Kyu; Lee, Jae Hwan; Shin, Eun Seok; Kim, Kee Sik.

In: Cardiovascular Diabetology, Vol. 14, No. 1, 141, 15.10.2015.

Research output: Contribution to journalArticle

Won, KB, Hur, SH, Cho, YK, Yoon, HJ, Nam, CW, Kim, KB, Bae, JH, Choi, DJ, Ahn, YK, Park, JS, Kim, HS, Choi, RK, Choi, D, Kim, JH, Han, KR, Park, HS, Choi, SY, Yoon, JH, Kwon, HC, Rha, S-W, Hwang, KK, Lim, D-S, Jung, KT, Oh, SK, Lee, JH, Shin, ES & Kim, KS 2015, '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', Cardiovascular Diabetology, vol. 14, no. 1, 141. https://doi.org/10.1186/s12933-015-0305-1
Won, Ki Bum ; Hur, Seung Ho ; Cho, Yun Kyeong ; Yoon, Hyuck Jun ; Nam, Chang Wook ; Kim, Kwon Bae ; Bae, Jang Ho ; Choi, Dong Ju ; Ahn, Young Keun ; Park, Jong Seon ; Kim, Hyo Soo ; Choi, Rak Kyeong ; Choi, Donghoon ; Kim, Joon Hong ; Han, Kyoo Rok ; Park, Hun Sik ; Choi, So Yeon ; Yoon, Jung Han ; Kwon, Hyeon Cheol ; Rha, Seung-Woon ; Hwang, Kyung Kuk ; Lim, Do-Sun ; Jung, Kyung Tae ; Oh, Seok Kyu ; Lee, Jae Hwan ; Shin, Eun Seok ; Kim, Kee Sik. / 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. In: Cardiovascular Diabetology. 2015 ; Vol. 14, No. 1.
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title = "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",
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 = "Acute myocardial infarction, Obesity, Survival, Type 2 diabetes mellitus",
author = "Won, {Ki Bum} and Hur, {Seung Ho} and Cho, {Yun Kyeong} and Yoon, {Hyuck Jun} and Nam, {Chang Wook} and Kim, {Kwon Bae} and Bae, {Jang Ho} and Choi, {Dong Ju} and Ahn, {Young Keun} and Park, {Jong Seon} and Kim, {Hyo Soo} and Choi, {Rak Kyeong} and Donghoon Choi and Kim, {Joon Hong} and Han, {Kyoo Rok} and Park, {Hun Sik} and Choi, {So Yeon} and Yoon, {Jung Han} and Kwon, {Hyeon Cheol} and Seung-Woon Rha and Hwang, {Kyung Kuk} and Do-Sun Lim and Jung, {Kyung Tae} and Oh, {Seok Kyu} and Lee, {Jae Hwan} and Shin, {Eun Seok} and Kim, {Kee Sik}",
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TY - JOUR

T1 - Comparison of 2-year mortality according to obesity in stabilized patients with type 2 diabetes mellitus after acute myocardial infarction

T2 - Results from the DIAMOND prospective cohort registry

AU - Won, Ki Bum

AU - Hur, Seung Ho

AU - Cho, Yun Kyeong

AU - Yoon, Hyuck Jun

AU - Nam, Chang Wook

AU - Kim, Kwon Bae

AU - Bae, Jang Ho

AU - Choi, Dong Ju

AU - Ahn, Young Keun

AU - Park, Jong Seon

AU - Kim, Hyo Soo

AU - Choi, Rak Kyeong

AU - Choi, Donghoon

AU - Kim, Joon Hong

AU - Han, Kyoo Rok

AU - Park, Hun Sik

AU - Choi, So Yeon

AU - Yoon, Jung Han

AU - Kwon, Hyeon Cheol

AU - Rha, Seung-Woon

AU - Hwang, Kyung Kuk

AU - Lim, Do-Sun

AU - Jung, Kyung Tae

AU - Oh, Seok Kyu

AU - Lee, Jae Hwan

AU - Shin, Eun Seok

AU - Kim, Kee Sik

PY - 2015/10/15

Y1 - 2015/10/15

N2 - 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.

AB - 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.

KW - Acute myocardial infarction

KW - Obesity

KW - Survival

KW - Type 2 diabetes mellitus

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U2 - 10.1186/s12933-015-0305-1

DO - 10.1186/s12933-015-0305-1

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VL - 14

JO - Cardiovascular Diabetology

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SN - 1475-2840

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