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Multi-Vessel Disease in Metabolically Healthy Obese Patients Presenting with ST-Elevation Myocardial Infarction.
- Source :
-
The Israel Medical Association journal : IMAJ [Isr Med Assoc J] 2022 Jan; Vol. 24 (1), pp. 52-56. - Publication Year :
- 2022
-
Abstract
- Background: The extent and impact of obesity as an isolated risk factor for coronary artery disease is not clear since co-morbidities serve as confounders and may mask this association.<br />Objectives: To examine whether obesity is associated with extensive coronary artery disease among metabolically healthy patients presenting with ST-elevation myocardial infarction (STEMI) and to explore the outcomes according to body mass index (BMI).<br />Methods: We stratified STEMI patients who had a metabolically healthy phenotype and available weight and height data according to BMI: 18.5-25 kg/m² (lean), 25.01-30 kg/m² (overweight), and > 30 kg/m² (obese).<br />Results: Overall 381 patients were included, 42% lean, 41% overweight, and 17% obese. Patients with increased BMIs had higher levels of low-density proteins and triglycerides (P < 0.05). Obese patients presented with the lowest rates of multi-vessel disease (12.9% vs. 22.9% for overweight and 28% for lean). In a univariable analysis, obese patients were 60% less likely to be diagnosed with multi-vessel disease (odds ratio 0.4, 95% confidence interval 0.2-0.9, P = 0.021) compared to lean patients. The association remained significant in a multivariable model adjusted for baseline characteristics (P = 0.029). There were no differences in 30-day or long-term mortality (median follow-up 3.2 years) among the groups (P > 0.1 for all comparisons).<br />Conclusions: Metabolically healthy phenotype obesity was associated with lower rates of multi-vessel disease despite higher levels of triglycerides. However, this association did not translate into increased mortality.
- Subjects :
- Body Mass Index
Cholesterol blood
Comorbidity
Coronary Angiography methods
Coronary Angiography statistics & numerical data
Coronary Vessels diagnostic imaging
Correlation of Data
Female
Humans
Lipoproteins, LDL blood
Male
Middle Aged
Mortality
Outcome Assessment, Health Care
Percutaneous Coronary Intervention methods
Risk Assessment methods
Severity of Illness Index
Triglycerides blood
Coronary Artery Disease complications
Coronary Artery Disease diagnosis
Coronary Artery Disease epidemiology
Coronary Artery Disease metabolism
Obesity, Metabolically Benign blood
Obesity, Metabolically Benign diagnosis
Obesity, Metabolically Benign epidemiology
ST Elevation Myocardial Infarction complications
ST Elevation Myocardial Infarction mortality
ST Elevation Myocardial Infarction physiopathology
ST Elevation Myocardial Infarction therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1565-1088
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Israel Medical Association journal : IMAJ
- Publication Type :
- Academic Journal
- Accession number :
- 35077046