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

Authors
Kang, Won YuJeong, Myung HoAhn, Young KeunKim, Jong HyunChae, Shung ChullKim, Young JoHur, Seung HoSeong, In WhanHong, Taek JongChoi, Dong HoonCho, Myeong ChanKim, Chong JinSeung, Ki BaeChung, Wook SungJang, Yang SooRha, Seung WoonBae, Jang HoCho, Jeong GwanPark, Seung Jung
Issue Date
Jan-2010
Publisher
ELSEVIER
Keywords
Acute myocardial infarction; Coronary artery disease; Obesity; Prognosis
Citation
JOURNAL OF CARDIOLOGY, v.55, no.1, pp.84 - 91
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF CARDIOLOGY
Volume
55
Number
1
Start Page
84
End Page
91
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/117257
DOI
10.1016/j.jjcc.2009.10.004
ISSN
0914-5087
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<23.0kg/m(2), n=1253); overweight (23.0 <= BMI<27.5kg/m(2), n = 1959); and obese (BMI >= 27.5kg/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. (C) 2009 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved.
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