Evaluation of the impact of statin therapy on the obesity paradox in patients with acute myocardial infarction

Ki Bum Won, Seung Ho Hur, Chang Wook Nam, Soe Hee Ann, Gyung Min Park, Sang Gon Lee, Hyo Eun Kim, Yun Kyeong Cho, Hyuck Jun Yoon, Hyoung Seob Park, Hyungseop Kim, Seongwook Han, Myung Ho Jeong, Young Keun Ahn, Seung-Woon Rha, Chong Jin Kim, Myeong Chan Cho, Hyo Soo Kim, Shung Chull Chae, Kee Sik KimYoung Jo Kim, Kwon Bae Kim, Philip Barter

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2 Citations (Scopus)

Abstract

The phenomenon of obesity paradox after acute myocardial infarction (AMI) has been reported under strong recommendation of statin therapy. However, the impact of statin therapy on this paradox has not been investigated. This study investigated the impact of statin therapy on 1-year mortality according to obesity after AMI. A total of 2745 AMI patients were included from the Korea Acute Myocardial Infarction Registry after 1:4 propensity score matching analysis (n = 549 for nonstatin group and n = 2196 for statin group). Primary and secondary outcomes were all-cause and cardiac death, respectively. During 1-year follow-up, the incidence of all-cause (8.4% vs 3.7%) and cardiac (6.2% vs 2.3%) death was higher in nonstatin group than in statin (P < .001, respectively). In nonstatin group, the incidence of all-cause (7.2% vs 9.0%) and cardiac (5.5% vs 6.5%) death did not differ significantly between obese and nonobese patients. However, in statin group, obese patients had lower 1-year rate of all-cause (1.7% vs 4.8%) and cardiac (1.2% vs 2.9%) death (P < .05, respectively), and lower cumulative rates by Kaplan-Meier analysis of all-cause and cardiac death compared with nonobese patients (log-rank P < .05, respectively). The overall risk of all-cause death was significantly lower in obese than in nonobese patients only in statin group (hazard ratio: 0.35; P = .001). After adjusting for confounding factors, obesity was independently associated with decreased risk of all-cause death in statin group. In conclusion, the greater benefit of statin therapy for survival in obese patients is further confirmation of the obesity paradox after AMI.

Original languageEnglish
Article numbere7180
JournalMedicine (United States)
Volume96
Issue number35
DOIs
Publication statusPublished - 2017 Sep 1

Keywords

  • acute myocardial infarction
  • mortality
  • obesity
  • statins

ASJC Scopus subject areas

  • Medicine(all)

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    Won, K. B., Hur, S. H., Nam, C. W., Ann, S. H., Park, G. M., Lee, S. G., Kim, H. E., Cho, Y. K., Yoon, H. J., Park, H. S., Kim, H., Han, S., Jeong, M. H., Ahn, Y. K., Rha, S-W., Kim, C. J., Cho, M. C., Kim, H. S., Chae, S. C., ... Barter, P. (2017). Evaluation of the impact of statin therapy on the obesity paradox in patients with acute myocardial infarction. Medicine (United States), 96(35), [e7180]. https://doi.org/10.1097/MD.0000000000007180