Prognostic impact of body mass index on in-hospital bleeding complications after ST-segment elevation myocardial...

Area of Science:

• Cardiology
• Clinical Research
• Obesity Medicine

Background:

• ST-elevation myocardial infarction (STEMI) is a leading cause of mortality despite advanced treatments.
• Individualized patient management is crucial for improving outcomes after STEMI.
• The role of in-hospital bleeding complications in STEMI prognosis warrants further investigation.

Purpose of the Study:

• To investigate the association between in-hospital bleeding complications and prognosis in patients with STEMI.
• To explore whether body mass index (BMI) influences the impact of bleeding complications on STEMI outcomes.

Main Methods:

• Prospective inclusion of 2070 STEMI patients from January 2005 to December 2012 in the "Registre d'Infarctus Maine-Anjou" cohort.
• Recording of Bleeding Academic Research Consortium (BARC) in-hospital bleeding complications.
• Analysis of one-year cardiovascular mortality stratified by BMI categories (normal weight, overweight, obese).

Main Results:

• One-year cardiovascular mortality was significantly higher in normal weight patients (BMI < 25 kg/m²) compared to overweight or obese patients (BMI ≥ 25 kg/m²).
• A significant interaction was observed between BARC 3 bleeding events and BMI groups regarding mortality.
• Normal weight patients experiencing BARC 3 bleeding had a substantially worse prognosis than overweight or obese patients with similar bleeding events.

Conclusions:

• Normal weight patients exhibit higher rates of in-hospital bleeding complications following STEMI.
• Lower survival rates in normal weight STEMI patients may be attributed to a greater vulnerability to bleeding complications.
• Body weight, specifically normal weight, is a critical factor influencing STEMI prognosis in the context of bleeding events.