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Prior studies have noted paradoxically lower in-hospital mortality in obese patients with non-ST-elevation myocardial infarction (NSTEMI) relative to those with normal body mass index (BMI). Whether these associations persist for long-term outcomes is unknown.
We linked detailed in-hospital data for 34465 NSTEMI patients >65 years of age in the CRUSADE study to Medicare records to obtain longitudinal outcomes. Patients were categorized into 6 groups according to BMI (kg/m2) as defined by the World Health Organization's standards (see Table for definition). We used Cox proportional hazards models adjusted for baseline clinical characteristics to estimate rates of all-cause mortality by BMI class for 3 years following hospital discharge.
The majority of patients in CRUSADE were overweight or obese (64.0%). These patients were younger and more likely to have hypertension, diabetes, and dyslipidemia than normal or underweight patients. Overall, 3-year all-cause mortality was 36.6%. After adjustment, overweight or obese patients had lower 3-year mortality than underweight and normal weight patients (Table).
A U-shaped association between weight and outcomes persists over time following NSTEMI with lower mortality among overweight or obese patients.
West, Room 3020
Saturday, March 09, 2013, 8:45 a.m.-9:00 a.m.
Session Title: ACS: Vulnerable and Underrepresented Populations
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 902-6
- 2013 American College of Cardiology Foundation