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BMI Modifies Increased Mortality Risk of Post-PCI STEMI Patients with AKI

Reut Schvartz1, Lior Lupu2, Shir Frydman2

  • 1Department of Anesthesia Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv 62431, Israel.

Journal of Clinical Medicine
|October 27, 2022
PubMed

Insights

Acute kidney injury (AKI) increases mortality in ST-elevation myocardial infarction (STEMI) patients post-percutaneous coronary intervention (PCI). However, higher body mass index (BMI) shows a protective effect, improving survival rates in these high-risk patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • Acute ST-elevation myocardial infarction (STEMI) mortality reduced by percutaneous coronary intervention (PCI).
  • Acute kidney injury (AKI) remains a significant predictor of mortality in STEMI patients post-PCI.
  • Overweight's protective role in STEMI and AKI separately is known, but not concurrently.

Purpose of the Study:

  • To investigate the association between AKI and mortality in STEMI patients undergoing PCI.
  • To determine if body mass index (BMI) offers a protective effect on mortality in this patient cohort.

Main Methods:

  • Retrospective analysis of 2,141 STEMI patients undergoing PCI from 2008-2016.
  • Comparison of all-cause mortality between patients with and without AKI post-PCI.
  • Logistic regression and survival analyses to assess the impact of AKI and BMI on mortality.

Main Results:

  • 178 patients (10%) developed AKI, associated with significantly higher 30-day and overall mortality (p < 0.001).
  • Logistic regression confirmed AKI as a significant risk factor for mortality.
  • Higher BMI demonstrated a significant protective effect on both 30-day and overall survival.

Conclusions:

  • AKI is a major risk factor for mortality and poor survival following PCI for STEMI.
  • Increased BMI may have a beneficial, protective effect on survival in STEMI patients who develop AKI post-PCI.

Keywords:
AKIPCISTEMIobesity paradox

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