Influence of obesity on the prognosis of patients with STEMI

doi:10.3969/j.issn.1006-7795.2022.02.005

Abstract

Abstract: Objective To investigate the effect of obesity level on the prognosis of patients with ST-segment elevation myocardial infarction(STEMI). Methods One thousand five hundreds and fifty-three patients admitted to our hospital from October 2013 to December 2018 were categorized into group A[underweight, body mass index (BMI)<18.5 kg/m²], group B(normal weight, 18.5 kg/m²≤BMI <24 kg/m²), group C(overweight,24.0 kg/m²≤BMI<28.0 kg/m²), and group D(obesity, BMI≥28.0 kg/m²) according to their body mass index (BMI)(kg/m²). Mortality and rates of major adverse cardiovascular and cerebrovascular events (MACCE) were compared between the four groups at hospital and 6-year follow-up. Results Underweight group has more male patients compared with the other three groups, and is older than the other three groups. The overall trend of the rate of revascularization during hospital is rising as BMI increases. The mortality rates of underweight group, normal weight group, overweight group and obesity group during hospitalization were 14.71%, 3.97%, 2.89% and 3.09% (P=0.003), respectively. The mortality of underweight group was significantly higher than the mortality of overweight group and obesity group. The expected five-year all-cause mortality rates shown in the Kaplan-Meier survival curves for patients in underweight group, normal weight group, overweight group and obesity group were 37.0%, 19.5%, 13.8%, and 13.0% (P=0.040), respectively. The expected five-year all-cause mortality is significantly higher in underweight group than in the other three groups. The Cox regression model fitted with restricted cubic spline (RCS) shows that there is a U-shaped relationship between BMI and follow-up death and the risk of MACCE. After correcting the mixed factors with Cox regression model, BMI is not an independent predictor of long-term death or MACCE in STEMI patients. Conclusion The level of obesity had no direct effect on the long-term prognosis of STEMI patients.

Key words: obesity, body mass index, acute ST-segment elevation myocardial infarction, prognosis

CLC Number:

R541.4

Miao Zupei, Zhang Yinghua, Xiao Keling, Si Jin, Zhang Haoyu, Li Jing. Influence of obesity on the prognosis of patients with STEMI[J]. Journal of Capital Medical University, 2022, 43(2): 192-198.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.02.005

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I2/192

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