Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction

Won Yu Kang, Myung Ho Jeong, Young Keun Ahn, Jong Hyun Kim, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Wook Sung Chung, Yang Soo Jang, Seung-Woon Rha, Jang Ho Bae, Jeong Gwan Cho, Seung Jung Park

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Abstract

The effect of body mass index (BMI) on outcomes after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not well known. In patients registered in the Korean Acute Myocardial Infarction Registry (KAMIR) between November 2005 and November 2007, 3824 STEMI patients who arrived at hospital within 12 h after onset of chest pain and underwent primary PCI were analyzed, and divided into four groups according to their BMI: underweight (BMI < 18.5 kg/m 2, n = 129); normal weight (18.5 ≤ BMI < 23.0 kg/m 2, n = 1253); overweight (23.0 ≤ BMI < 27.5 kg/m 2, n = 1959); and obese (BMI ≥ 27.5 kg/m 2, n = 483). In-hospital mortality, revascularization in 1 year, mortality in 1 year, and overall mortality were compared between groups. Overweight and obese group were significantly younger, had normal left ventricular ejection fraction, and were more likely to be men with a higher incidence of hypertension, diabetes, and hyperlipidemia. There were no significant differences in symptom-to-door time and door-to-balloon time between groups. Obese patients had significantly lower in-hospital and overall mortalities. Major adverse cardiac events showed a bimodal pattern. Obese STEMI patients treated with primary PCI were associated with lower mortality, which may be explained by better use of medical treatment, hemodynamic stability, and younger age.

Original languageEnglish
Pages (from-to)84-91
Number of pages8
JournalJournal of Cardiology
Volume55
Issue number1
DOIs
Publication statusPublished - 2010 Jan 1

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Keywords

  • Acute myocardial infarction
  • Coronary artery disease
  • Obesity
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kang, W. Y., Jeong, M. H., Ahn, Y. K., Kim, J. H., Chae, S. C., Kim, Y. J., Hur, S. H., Seong, I. W., Hong, T. J., Choi, D. H., Cho, M. C., Kim, C. J., Seung, K. B., Chung, W. S., Jang, Y. S., Rha, S-W., Bae, J. H., Cho, J. G., & Park, S. J. (2010). Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Journal of Cardiology, 55(1), 84-91. https://doi.org/10.1016/j.jjcc.2009.10.004