| 강원유, 정명호, 안영근, 김종현, 채성철, 김영조, 허승호, 성인환, 홍택종, 최동훈, 조명찬, 김종진, 승기배, 정욱성, 장양수, 나승운, 배장호, 조정관, 박승정 외 Korea Acute Myocardial Infarction Registry Investigators |
Background: Some data concerning the relationship between body mass index (BMI) and coronary artery disease exist. But, clinical effect of BMI on outcomes after percutaneous coronary intervention (PCI) in the patients with ST-segment elevation myocardial infarction (STEMI) well not known.
Methods: In patients registered in the Korean Acute Myocardial Infarction Registry (KAMIR) between November 2005 and November 2006, 1862 STEMI patients who arrived at hospital within 12 hours after onset of chest pain and underwent PCI were analyzed and divided into 3 groups according to their BMI: underweight (Group I: BMI<21 kg/㎡, n=304), normal weight (Group II, 21≤BMI<25 kg/㎡, n=901) and overweight (Group III: BMI≥25 kg/㎡, n=657). In-hospital mortality, re-PCI in 1 year, mortality in 1 year, and overall mortality were compared between groups.
Results: Overweight group was significantly younger (Group I: 69.5±12.5, Group II: 62.9±12.1, Group III: 58.6±12.2, p<0.001) and more likely to be men (Group I: 65.8%, II: 77.1%, III: 78.2%, p<0.001) with a higher incidence of hypertension (Group I: 36.2%, II: 41.3%, III: 52.5%, p<0.001), diabetes (Group I: 6.1%, II: 6.9%, III: 11.2%, p=0.006), hyperlipidemia (Group I: 36.2%, II: 41.3%, III: 52.5%, p=0.008). There was no significant statistical differences in symptom-to-door time and door-to-balloon time (p>0.05). Underweight patients had lower left ventricular ejection fraction (Group I: 48.1±11.8%, II: 51.0±11.4, III: 52.2±11.8, p<0.001) and higher regional wall motion score (Group I: 20.0±10, II: 17.7±11.2, III: 17.8±10.8, p=.0.016). Obese patients had significantly lower mortalities (In-hospital mortality: 5.6% in Group I, 3.6% in II, 2.6% in III, p=0.024, mortality at one-year: 6.3% in Group I, 4.2% in II, 2.2% in III, p=0.026, overall mortality: 16.1% in Group I, 10.8% in II, 7.0% in III, p=0.002 ). In contrast, re-PCI at one-year was higher in Group III (Group I: 7.6%, II: 9.6%, III: 14.3%, p=0.014).
Conclusion: Despite obesity is an important risk factor for coronary artery disease, obese STEMI patients treated with PCI are associated with lower mortality.
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