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Inverted U-shaped relationship between body mass index and multivessel lesions in Chinese patients with myocardial
Dandan Sun1, Wei Li1, Hongmin Zhang1
1Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
Insights
The study found an inverted U-shaped relationship between body mass index (BMI) and multivessel coronary artery disease in myocardial infarction patients. An obesity paradox exists for BMI over 26.3 kg/m²
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Myocardial infarction (MI) is a leading cause of mortality worldwide.
- The role of body mass index (BMI) in the severity of coronary artery disease (CAD) post-MI requires further investigation.
- Understanding BMI's association with multivessel CAD is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the association between body mass index (BMI) and the presence of multivessel coronary artery disease (CAD) in patients who have experienced a myocardial infarction (MI).
Main Methods:
- A cohort of 1566 patients with myocardial infarction was analyzed.
- Body mass index (BMI) was measured at baseline.
- Multivessel coronary artery disease was the dependent variable, with numerous covariates controlled for, including age, blood pressure, and lipid profiles.
Main Results:
- A nonlinear, inverted U-shaped relationship was observed between BMI and multivessel CAD.
- The inflection point for this relationship was identified at a BMI of 26.3 kg/m².
- Effect sizes indicated a protective association at higher BMIs (OR 0.85) and a risk association at lower BMIs (OR 1.10).
Conclusions:
- An obesity paradox is suggested for patients with BMI > 26.3 kg/m² following MI.
- Further research is warranted to explore the link between BMI and MI prognosis.
- BMI management may play a role in improving outcomes for myocardial infarction patients.
Objective:
To investigate the association of body mass index (BMI) with multivessel coronary artery disease in patients with myocardial infarction.
Methods:
This study was performed in 1566 patients with myocardial infarction in the Department of Cardiology, Affiliated Hospital of Jining Medical University, China. Independent and dependent variables were BMI measured at baseline and multivessel coronary artery disease, respectively. The covariates examined in this study were age, systolic blood pressure, diastolic blood pressure, heart rate, creatinine, uric acid, bilirubin, cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, left ventricular ejection fraction, sex, heart failure, atrial fibrillation, chronic obstructive pulmonary disease, stroke, hypertension, diabetes mellitus, and smoking.
Results:
A nonlinear relationship was detected between BMI and multivessel coronary artery disease, and this was an inverted U-shaped curve and the cutoff point was 26.3 kg/m2. The effect sizes and confidence intervals on the left and right sides of the inflection point were 1.10 (1.01-1.20) and 0.85 (0.74-0.97), respectively.
Conclusions:
There is an obesity paradox for BMI > 26.3 kg/m2. Future studies should examine the relationship between BMI and prognosis in patients with myocardial infarction, which may be important for improving the prognosis through control of BMI.
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