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

Title
Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction
Author(s)
김영조강원유[강원유]정명호[정명호]안영근[안영근]김종현[김종현]채성철[채성철]허성호[허성호]성인환[성인환]홍택종[홍택종]최동훈[최동훈]조명찬[조명찬]김총진[김총진]성기배[성기배]정욱성[정욱성]장양수[장양수]라성운[라성운]배장호[배장호]조정관[조정관]박성정[박성정]
Keywords
BODY-MASS INDEX; EARLY INVASIVE MANAGEMENT; LONG-TERM OUTCOMES; ARTERY-DISEASE; NATRIURETIC PEPTIDE; PRIMARY ANGIOPLASTY; ELDERLY-PATIENTS; IMPACT; MORTALITY; RISK
Issue Date
201001
Publisher
ELSEVIER IRELAND LTD
Citation
JOURNAL OF CARDIOLOGY, v.55, no.1, pp.84 - 91
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.
URI
http://hdl.handle.net/YU.REPOSITORY/22993http://dx.doi.org/10.1016/j.jjcc.2009.10.004
ISSN
0914-5087
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의과대학 > 내과학교실 > Articles
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