Influence of obesity and metabolic syndrome on clinical outcomes of ST-segment elevation myocardial infarction in men undergoing primary percutaneous coronary intervention

Other Korea Acute Myocardial Infarction Registry (KAMIR) investigators

Research output: Contribution to journalArticle

Abstract

Background: The correlation between obesity and metabolic syndrome (MetS) and its impact on cardiovascular disease remains unclear. This study aims to investigate the impact of metabolic status and obesity on clinical outcomes of male patients with ST-segment elevation myocardial infarction (STEMI). Methods: Data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were used to evaluate the impact of obesity and MetS on patients undergoing primary percutaneous coronary intervention (PPCI) from November 2005 to November 2015. Patients were grouped according to the presence or absence of obesity and MetS (‘obese−/MetS−’, ‘obese−/MetS+’, ‘obese+/MetS−’, or ‘obese+/MetS+’, respectively). All-cause death and major adverse cardiac events (MACE) were recorded during 12 months of follow-up. Results: A total of 14,357 patients were included. Multivariate analysis showed that the presence of MetS was an independent risk factor for all-cause death (HR 2.08, 95% CI 1.30–3.31, p = 0.002) and cardiovascular death (HR 2.44, 95% CI 1.33–4.46, p = 0.004) at 12 months among normal weight patients. The protective effect of obesity was observed, compared with the obese−/MetS+ group, in terms of all-cause death (HR 0.50, 95% CI 0.31–0.81, p = 0.005) and cardiovascular death (HR 0.52, 95% CI 0.28–0.96, p = 0.038; vs. total obese individuals), but it might have disappeared compared with the obese−/MetS− group. The rate of MACE did not differ significantly according to category by obesity and MetS. Conclusions: The obesity paradox has not been observed between obese and normal weight patients without MetS. Risk stratification on the basis of the presence or absence of MetS is not a clinically useful indicator of outcome in obese male patients with STEMI after PPCI.

Original languageEnglish
JournalJournal of Cardiology
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Percutaneous Coronary Intervention
Obesity
Cause of Death
ST Elevation Myocardial Infarction
Registries
Weights and Measures
National Institutes of Health (U.S.)
Korea
Cardiovascular Diseases
Multivariate Analysis
Myocardial Infarction

Keywords

  • Metabolic syndrome
  • Myocardial infarction
  • Obesity
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Influence of obesity and metabolic syndrome on clinical outcomes of ST-segment elevation myocardial infarction in men undergoing primary percutaneous coronary intervention. / Other Korea Acute Myocardial Infarction Registry (KAMIR) investigators.

In: Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

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title = "Influence of obesity and metabolic syndrome on clinical outcomes of ST-segment elevation myocardial infarction in men undergoing primary percutaneous coronary intervention",
abstract = "Background: The correlation between obesity and metabolic syndrome (MetS) and its impact on cardiovascular disease remains unclear. This study aims to investigate the impact of metabolic status and obesity on clinical outcomes of male patients with ST-segment elevation myocardial infarction (STEMI). Methods: Data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were used to evaluate the impact of obesity and MetS on patients undergoing primary percutaneous coronary intervention (PPCI) from November 2005 to November 2015. Patients were grouped according to the presence or absence of obesity and MetS (‘obese−/MetS−’, ‘obese−/MetS+’, ‘obese+/MetS−’, or ‘obese+/MetS+’, respectively). All-cause death and major adverse cardiac events (MACE) were recorded during 12 months of follow-up. Results: A total of 14,357 patients were included. Multivariate analysis showed that the presence of MetS was an independent risk factor for all-cause death (HR 2.08, 95{\%} CI 1.30–3.31, p = 0.002) and cardiovascular death (HR 2.44, 95{\%} CI 1.33–4.46, p = 0.004) at 12 months among normal weight patients. The protective effect of obesity was observed, compared with the obese−/MetS+ group, in terms of all-cause death (HR 0.50, 95{\%} CI 0.31–0.81, p = 0.005) and cardiovascular death (HR 0.52, 95{\%} CI 0.28–0.96, p = 0.038; vs. total obese individuals), but it might have disappeared compared with the obese−/MetS− group. The rate of MACE did not differ significantly according to category by obesity and MetS. Conclusions: The obesity paradox has not been observed between obese and normal weight patients without MetS. Risk stratification on the basis of the presence or absence of MetS is not a clinically useful indicator of outcome in obese male patients with STEMI after PPCI.",
keywords = "Metabolic syndrome, Myocardial infarction, Obesity, Prognosis",
author = "{Other Korea Acute Myocardial Infarction Registry (KAMIR) investigators} and Lee, {Seung Hun} and Jeong, {Myung Ho} and Kim, {Ju Han} and Kim, {Min Chul} and Sim, {Doo Sun} and Hong, {Young Joon} and Youngkeun Ahn and Chae, {Shung Chull} and Seong, {In Whan} and Park, {Jong Sun} and Chae, {Jei Keon} and Hur, {Seung Ho} and Cha, {Kwang Soo} and Kim, {Hyo Soo} and Gwon, {Hyeon Cheol} and Seung, {Ki Bae} and Seung-Woon Rha",
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language = "English",
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AU - Other Korea Acute Myocardial Infarction Registry (KAMIR) investigators

AU - Lee, Seung Hun

AU - Jeong, Myung Ho

AU - Kim, Ju Han

AU - Kim, Min Chul

AU - Sim, Doo Sun

AU - Hong, Young Joon

AU - Ahn, Youngkeun

AU - Chae, Shung Chull

AU - Seong, In Whan

AU - Park, Jong Sun

AU - Chae, Jei Keon

AU - Hur, Seung Ho

AU - Cha, Kwang Soo

AU - Kim, Hyo Soo

AU - Gwon, Hyeon Cheol

AU - Seung, Ki Bae

AU - Rha, Seung-Woon

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The correlation between obesity and metabolic syndrome (MetS) and its impact on cardiovascular disease remains unclear. This study aims to investigate the impact of metabolic status and obesity on clinical outcomes of male patients with ST-segment elevation myocardial infarction (STEMI). Methods: Data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were used to evaluate the impact of obesity and MetS on patients undergoing primary percutaneous coronary intervention (PPCI) from November 2005 to November 2015. Patients were grouped according to the presence or absence of obesity and MetS (‘obese−/MetS−’, ‘obese−/MetS+’, ‘obese+/MetS−’, or ‘obese+/MetS+’, respectively). All-cause death and major adverse cardiac events (MACE) were recorded during 12 months of follow-up. Results: A total of 14,357 patients were included. Multivariate analysis showed that the presence of MetS was an independent risk factor for all-cause death (HR 2.08, 95% CI 1.30–3.31, p = 0.002) and cardiovascular death (HR 2.44, 95% CI 1.33–4.46, p = 0.004) at 12 months among normal weight patients. The protective effect of obesity was observed, compared with the obese−/MetS+ group, in terms of all-cause death (HR 0.50, 95% CI 0.31–0.81, p = 0.005) and cardiovascular death (HR 0.52, 95% CI 0.28–0.96, p = 0.038; vs. total obese individuals), but it might have disappeared compared with the obese−/MetS− group. The rate of MACE did not differ significantly according to category by obesity and MetS. Conclusions: The obesity paradox has not been observed between obese and normal weight patients without MetS. Risk stratification on the basis of the presence or absence of MetS is not a clinically useful indicator of outcome in obese male patients with STEMI after PPCI.

AB - Background: The correlation between obesity and metabolic syndrome (MetS) and its impact on cardiovascular disease remains unclear. This study aims to investigate the impact of metabolic status and obesity on clinical outcomes of male patients with ST-segment elevation myocardial infarction (STEMI). Methods: Data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were used to evaluate the impact of obesity and MetS on patients undergoing primary percutaneous coronary intervention (PPCI) from November 2005 to November 2015. Patients were grouped according to the presence or absence of obesity and MetS (‘obese−/MetS−’, ‘obese−/MetS+’, ‘obese+/MetS−’, or ‘obese+/MetS+’, respectively). All-cause death and major adverse cardiac events (MACE) were recorded during 12 months of follow-up. Results: A total of 14,357 patients were included. Multivariate analysis showed that the presence of MetS was an independent risk factor for all-cause death (HR 2.08, 95% CI 1.30–3.31, p = 0.002) and cardiovascular death (HR 2.44, 95% CI 1.33–4.46, p = 0.004) at 12 months among normal weight patients. The protective effect of obesity was observed, compared with the obese−/MetS+ group, in terms of all-cause death (HR 0.50, 95% CI 0.31–0.81, p = 0.005) and cardiovascular death (HR 0.52, 95% CI 0.28–0.96, p = 0.038; vs. total obese individuals), but it might have disappeared compared with the obese−/MetS− group. The rate of MACE did not differ significantly according to category by obesity and MetS. Conclusions: The obesity paradox has not been observed between obese and normal weight patients without MetS. Risk stratification on the basis of the presence or absence of MetS is not a clinically useful indicator of outcome in obese male patients with STEMI after PPCI.

KW - Metabolic syndrome

KW - Myocardial infarction

KW - Obesity

KW - Prognosis

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JO - Journal of Cardiology

JF - Journal of Cardiology

SN - 0914-5087

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