Obesity is associated with premature occurrence of acute myocardial infarction
J A Suwaidi1, R S Wright, J P Grill
1Coronary Care Unit Group and the Mayo Physician Alliance for Clinical Trials (MPACT), Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55902, USA.
Insights
Obesity and overweight status are linked to younger age at acute myocardial infarction (AMI) presentation. This study found no increased in-hospital complications for these patients.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Obesity is a modifiable risk factor for coronary artery disease.
- The link between obesity and age at acute myocardial infarction (AMI) presentation is not well-established.
Purpose of the Study:
- To investigate the association between obesity and age at AMI presentation.
- To determine the impact of obesity on in-hospital morbidity and mortality in AMI patients.
Main Methods:
- Analysis of 906 Olmsted County patients admitted to Mayo Clinic Coronary Care Unit (CCU) with AMI.
- Data collected prospectively in the Mayo CCU Database.
- Evaluation of age at AMI, in-hospital morbidity, and mortality based on BMI categories.
Main Results:
- Obese and overweight patients presented with AMI at significantly younger ages (8.2 and 3.6 years younger, respectively) compared to normal-weight patients.
- Obesity and overweight status were independently associated with premature AMI, even after adjusting for other risk factors.
- No significant increase in in-hospital morbidity or mortality was observed in overweight or obese patients.
Conclusions:
- Overweight and obesity are independently associated with premature occurrence of AMI.
- Obesity does not appear to increase the incidence of in-hospital complications following AMI.
Background:
The American Heart Association has classified obesity as a major modifiable risk factor for coronary artery disease, but its relationship with age at presentation with acute myocardial infarction (AMI) is poorly documented.
Hypothesis:
The study was undertaken to evaluate the impact of obesity on age at presentation, and on in-hospital morbidity and mortality in patients with AMI.
Methods:
Our analysis includes a consecutive series of 906 Olmsted County patients (mean age 67.7 years, 51% male) admitted with AMI to the Mayo Clinic Coronary Care Unit (CCU). The patients were entered into the Mayo CCU Database, a prospective registry of data pertaining to patients admitted to the Mayo Clinic CCU with AMI. Age at AMI occurrence and in-hospital morbidity and mortality were noted.
Results:
Obese patients (body mass index [BMI] >30) with AMI were significantly younger than patients with AMI in the overweight (BMI 25-30) and normal-weight (BMI < 30) groups (62.3+/-13.1 vs. 66.9+/-13.2 and 72.9+/-13.4, respectively. p < 0.001). Obesity and overweight status were associated with male gender, diabetes mellitus, hypercholesterolemia, and smoking history; however, after multivariate adjustment for these risk factors, excess weight and premature AMI remained significantly associated. Compared with normal-weight patients, overweight patients presenting with AMI were 3.6 years younger (p < 0.001, confidence interval [CI] 1.9-5.4) and obese patients 8.2 years younger (p < 0.001, Cl 6.2-10.1). No significant increase in in-hospital morbidity and mortality was seen.
Conclusion:
In this population-based study, overweight and obese status are independently associated with the premature occurrence of AMI, but not with an increased incidence of in-hospital complications.
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