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ȣ - 510044 175 |
Overweight and/or Obesity Lowers Adverse Outcome Despite of Severe Coronary Artery Disease in Korean Acute Myocardial Infarction Patients |
Korea Acute Myocardial infarction Registry Investigators |
이기홍, 정명호, 안영근, 채성철, 김종현, 성인환, 김영조, 허승호, 최동훈, 홍택종, 윤정한, 류제영, 채제건, 김두일, 채인호, 구본권, 김병옥, 이내희, 황진용, 오석규, 조명찬, 김기식, 정경태, 이명용, 김종진, 정욱성, 나승운, 외 KAMIR 연구자 |
Background: Obesity is considered as the risk factor of coronary heart disease, but has been reported to endow better outcome after revasculization. To clarify the relation between obesity and coronary artery disease in acute myocardial infarction (AMI) patients, we examined the extent of coronary artery disease and short-term and long-term outcome after percutaneous coronary intervention (PCI). Methods: 5766 eligible patients (4061 males, 65.0±12.8 years) enrolled in Korea Acute Myocardial infarction Registry (KAMIR) were classified into 4 groups by WHO body mass index (BMI) criteria: underweight (<18.5 Kg/m2), normal weight (18.5-24.9 Kg/m2), overweight (25-29.9 Kg/m2), obesity (≥30 Kg/m2). Results: Hypertension, hypertriglyceridemia, abdominal obesity were more common in overweight/obese patients. High-risk coronary anatomy (significant left main artery and/or significant 3-vessel coronary artery disease) was less often in overweight/obese patients (26.5% vs. 29.5%, p=0.022), although pre-TIMI flow was lower (TIMI 3: 28.3% vs. 32.0%, p=0.008). Overweight/obese patients had lower 1-month major adverse cardiac events (MACE) (9.0% vs. 12.5%, p<0.001) and mortality (3.6% vs. 6.2%, p<0.001). After covariate adjustment, BMI ≥25 Kg/m2 still predicted lower MACE (OR, 0.784; CI, 0.631-0.976; p=0.029) and mortality (OR, 0.701; CI, 0.496-0.990; p=0.044). One-year MACE (2.4% vs. 6.2%, p<0.001) and mortality (0.5% vs. 3.3%, p<0.001) were lower in overweight/obese patients. Conclusions: Overweight/obese AMI patients have better short- and long-term outcomes despite of severe coronary artery disease.
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