Author + information
- Jung-Hee Lee1,
- Kang-Un Choi2,
- Ung Kim3,
- Chan-Hee Lee4,
- Jang-Won Son5,
- Jong-Seon Park6,
- Dong-Gu Shin7 and
- Young-Jo Kim8
- 1Yeungnam University Hospital, Daegu, Korea, Republic of
- 2Yeungnam University Hospital, Daegu, Korea, Republic of
- 3Yeungnam University Hospital, Daegu, Korea, Republic of
- 4Yeungnam University Hospital
- 5Yeungnam University Hospital
- 6Yeungnan Univ. Hospital, Daegu, Korea, Republic of
- 7Yeungnam University Hospital
- 8Yeungnam University Medical Center
The clinical impact of BMI especially in old age patients have not yet been sufficiently evaluated. The aim of this study was to investigate the clinical impact of body mass index (BMI) in old age patients (≥80 years) with acute myocardial infarction (AMI).
We analyzed a total of 2,489 AMI patients over 80 years from KAMIR/KorMI registry between November 2005 and March 2012. We categorized study population into four groups according to their BMI: group I (BMI<18.5kg/m2, n=301 [12.1%]), group II (18.5≤BMI<23.0kg/m2, n=1,150 [46.2%]), group III (23.0≤BMI<27.5kg/m2, n=890 [35.8%]), group IV (BMI≥27.5kg/m2, n=148 [5.9%]). The primary endpoint was major adverse cardiovascular events (MACEs), a composite of cardiac death, nonfatal myocardial infarction, target lesion revascularization and target vessel revascularization.
Baseline characteristics among four groups were similar except for hypertension (45.1% vs. 58.4% vs. 66.2% vs. 69.9%, respectively, p<0.001) and diabetes (16.6% vs. 23.6% vs. 30.7% vs. 35.1%, p<0.001). Intensive care unit (ICU) length of stay was significantly different among four groups during hospitalization (5.3±5.9 vs. 4.8±6.8 vs. 4.2±4.0 vs. 3.5±2.1 days, p=0.007). MACEs (16.9% vs. 14.9% vs. 13.7% vs. 8.8%, p=0.040) and cardiac death (10.3% vs. 8.4% vs. 7.9% vs. 4.1%, p=0.071) were less frequently occurred in group IV than in other groups during 1-year follow-up. A Cox proportional hazards multivariate regression model demonstrated overweight status (BMI≥27.5kg/m2) as an independent predictor of reduced MACEs (hazard ratio [HR] 0.20, 95% confidence interval [CI] 0.06-0.69, p=0.010) along with reduced left ventricular ejection fraction (<40%) as a predictor of increased MACEs (HR.1.87, 95% CI 1.31-2.68, p=0.001).
Overweight status was significantly associated with length of ICU stay and mid-term clinical outcome in old age patients with AMI. This study suggested that nutritional status of old age patients might be an important role for AMI management.
CORONARY: Acute Myocardial Infarction