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Published on: December 16, 2022

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

Won Yu Kang1, Myung Ho Jeong, Young Keun Ahn

  • 1Chonnam National University Hospital, South Korea.

Journal of Cardiology
|February 4, 2010
PubMed

Insights

Obese patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) had lower mortality rates. This finding suggests obesity may be linked to better outcomes in STEMI patients treated with PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Public Health

Background:

  • The relationship between body mass index (BMI) and outcomes following primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains unclear.
  • Understanding this association is crucial for optimizing patient care and risk stratification.

Purpose of the Study:

  • To investigate the impact of BMI on in-hospital and long-term outcomes in STEMI patients undergoing primary PCI.
  • To analyze mortality, revascularization rates, and major adverse cardiac events across different BMI categories.

Main Methods:

  • Analysis of 3824 STEMI patients from the Korean Acute Myocardial Infarction Registry (KAMIR) treated with primary PCI.
  • Patients were stratified into four BMI groups: underweight, normal weight, overweight, and obese.
  • Comparison of in-hospital mortality, 1-year mortality, 1-year revascularization, and overall mortality between groups.

Main Results:

  • Obese patients were younger, had better left ventricular ejection fraction, and a higher prevalence of hypertension, diabetes, and hyperlipidemia.
  • No significant differences in symptom-to-door or door-to-balloon times were observed across BMI groups.
  • Obese patients demonstrated significantly lower in-hospital and overall mortality rates, with major adverse cardiac events showing a bimodal pattern.

Conclusions:

  • Obesity in STEMI patients treated with primary PCI is associated with reduced mortality.
  • Potential explanations include better medical management, hemodynamic stability, and younger age in obese individuals.
  • Further research is warranted to elucidate the mechanisms behind the 'obesity paradox' in STEMI.

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