Influence of the Obesity on Clinical Outcomes in the Young Korean Patients with Acute ST-Elevation Myocardial Infarction

Abstract

Background: Previous reports have demonstrated that obese patients may have better clinical outcomes after percutaneous coronary intervention (PCI) than non-obesepatients; however this “obesity paradox” remains still unknown in young patients. Therefore, we investigated the influence of obesity on the outcomes of young patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 541 young patients (≤ 45 year old) with acute STEMI undergoing urgent PCI were enrolled in the Korea Acute Myocardial Infarction Registry betweenJanuary 2008 and Aug 2011. These patients were categorized according to their body mass index (BMI, kg/m2) as non-obese (BMI < 27.5, N = 73), obese (27.5 ≤ BMI < 32.5,N = 183) and morbidly obese (BMI ≥ 32.5, N = 285). At follow-up, the major adverse cardiac events (MACE; defined as death, myocardial infarction, and target vesselrevascularization) were compared among the three groups. Results: The mean duration of follow-up was 384 ± 82 days. Among the three groups, age, sex, cardiovascular risk factors and left ventricular ejection fraction were similar andnumber of infarct-related artery or stenotic coronary artery was also similar. The length of stay in the coronary care unit was shorter among the obese and morbidly obese group compared with that of the non-obese group. In-hospital death and clinical outcomes among the three groups were not significantly different. At follow-up, the one-year MACE-free survival rate of those groups was not significantly different (93% in non-obese, 94% in obese and 95% in morbidly obese). Conclusion: In young patients with STEMI undergoing urgent PCI, influence of obesity on clinical outcomes was not observed as significant in the young Korean patients.