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Body Mass Index and 1-Year Unplanned Readmission in Chinese Patients with Acute Myocardial Infarction: A
Dandan Sun1, Qingyun Zhang1, Wei Li2
1Department of Cardiology of Affiliated Hospital of Jining Medical University, 89# Guhuai Road, Rencheng District, Jining 272000, Shandong Province, China.
Insights
Body Mass Index (BMI) shows a nonlinear relationship with 1-year unplanned readmissions in Chinese acute myocardial infarction patients post-PCI. Overweight individuals (BMI > 29.3 kg/m²) experienced significantly higher readmission rates, refuting the obesity paradox.
Area of Science:
- Cardiology
- Public Health
- Clinical Research
Background:
- Limited evidence exists on the association between Body Mass Index (BMI) and 1-year unplanned readmissions.
- Investigating this relationship is crucial for patient management following acute myocardial infarction (AMI).
Purpose of the Study:
- To determine if BMI is an independent predictor of 1-year unplanned readmission in Chinese patients with AMI after percutaneous transluminal coronary intervention (PCI).
- To explore the nature of the relationship between BMI and readmission risk.
Main Methods:
- A cohort study involving 214 Chinese patients with AMI post-PCI (January 2017 - January 2018).
- Baseline BMI was the independent variable; 1-year unplanned readmission was the dependent variable.
- Statistical analysis adjusted for numerous covariates including demographics, clinical factors, and comorbidities.
Main Results:
- The study included 172 participants (68.6% male, average age 60.2 years).
- The overall 1-year unplanned readmission rate was 26.14%.
- A nonlinear relationship was observed between BMI and readmission, with an inflection point at BMI 29.3 kg/m². Overweight patients (BMI > 29.3) had a significantly increased risk (HR 2.8, 95% CI 1.3-5.8).
Conclusions:
- Body Mass Index exhibits a nonlinear association with 1-year unplanned readmission in myocardial infarction patients.
- Overweight status (BMI > 29.3 kg/m²) is linked to a significantly higher risk of readmission.
- The findings suggest the absence of an obesity paradox concerning readmission rates in this Chinese patient cohort.
Background:
Evidence regarding the relationship between body mass index (BMI) and 1-year unplanned readmission was limited. Therefore, the objective of this research is to investigate whether BMI was independently related to 1-year unplanned readmission in Chinese patients with acute myocardial infarction (AMI) after percutaneous transluminal coronary intervention (PCI) after adjusting for other covariates.
Methods:
The present study was a cohort study. A total of 214 participants with AMI after PCI were involved in a hospital in China from 1st January 2017 to 1st January 2018. The target independent variable and the dependent variable were BMI measured at baseline and 1-year unplanned readmission, respectively. Covariates involved in this study included age, gender, TC, triglyceride, HDL-C, LDL-C, PT, APTT, INR, creatinine, HGB, LVEF, discharge medication, marital status, educational level, COPD, diabetes mellitus, heart failure, history of ischemic stroke, history of hemorrhagic stroke, arrhythmia, and hypertension.
Results:
The average age of 172 selected participants was 60.2 ± 10.8 years old, and about 68.6% of them was male. The rate of readmission in patients with AMI was 26.14%. The result of fully adjusted binary logistic regression showed BMI was negatively associated with risk of readmission after adjusting confounders (hazard ratio (HR) = 1.1, 95% CI 0.93-1.29). Nonlinear relationship was detected between BMI and 1-year unplanned readmission, whose point was 29.3. The effect sizes and the confidence intervals of the left and right sides of inflection point were 0.9 (0.7-1.2, P for nonlinearity = 0.530) and 2.8 (1.3-5.8, P for nonlinearity = 0.530) and 2.8 (1.3-5.8.
Conclusion:
BMI has a nonlinear relationship with 1-year unplanned readmission in patients with myocardial infarction. The 1-year unplanned readmission rate of overweight patients (BMI > 29.3 kg/m2) has increased significantly. Obesity paradox does not exist in terms of readmission of Chinese patients with myocardial infarction after PCI.
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