Timóteo Ana Teresa, Ramos Ruben, Toste Alexandra, Oliveira José Alberto, Ferreira Maria Lurdes, Ferreira Rui Cruz
Cardiology Department, Santa Marta Hospital, Centro Hospitalar de Lisboa Central EPE, Portugal.
Acute Card Care. 2011 Sep;13(3):123-8. doi: 10.3109/17482941.2011.606469.
Obese patients submitted to elective coronary angioplasty have a paradoxical reduction in hospital and long-term mortality. In primary angioplasty setting, the relation with Body Mass Index (BMI) is less studied.
To evaluate the impact of obesity in the results after ST-segment elevation acute myocardial infarction treated by primary angioplasty.
Study of 539 consecutive patients with ST-segment elevation acute myocardial infarction (STEMI) submitted to primary angioplasty. We evaluated in-hospital, 30-day and one-year all-cause mortality according to BMI: 'normal', <25 kg/m(2); 'overweight', 25-29.9 kg/m(2) and 'obese', ≥ 30 kg/m(2).
Obese patients were younger, had more hypertension and hyperlipidemia. There were no differences in previous cardiac history and hospital data. In-hospital mortality was 8.0% for patients with normal BMI, 4.4% for overweight patients and 5.9% for obese patients (P=0.296). At 30 days, 9.6%, 5.2% and 6.9% (P=0.212) and at first year, 11.2%, 5.2% and 6.9% (P=0.064), respectively. Overweight was the only group with decreased risk (OR: 0.44, 95% CI: 0.21-0.90, P=0.015), even after adjustment for confounding variables (OR: 0.37, 95% CI: 0.15-0.95, P=0.038).
Overweight patients had a better prognosis after primary angioplasty for STEMI compared with other BMI groups.
接受择期冠状动脉血管成形术的肥胖患者在住院期间和长期死亡率方面出现了矛盾性的降低。在直接血管成形术的情况下，与体重指数（BMI）的关系研究较少。
评估肥胖对直接血管成形术治疗ST段抬高型急性心肌梗死后结果的影响。
对539例接受直接血管成形术的ST段抬高型急性心肌梗死（STEMI）连续患者进行研究。我们根据BMI评估了住院期间、30天和1年的全因死亡率：“正常”，<25kg/m²；“超重”，25-29.9kg/m²；“肥胖”，≥30kg/m²。
肥胖患者更年轻，患有更多高血压和高脂血症。既往心脏病史和住院数据无差异。BMI正常的患者住院死亡率为8.0%，超重患者为4.4%，肥胖患者为5.9%（P=0.296）。30天时分别为9.6%、5.2%和6.9%（P=0.212），第一年时分别为11.2%、5.2%和6.9%（P=0.064）。超重是唯一风险降低的组（OR：0.44，95%CI：0.21-0.90，P=0.015），即使在调整混杂变量后（OR：0.37，95%CI：0.15-0.95，P=0.038）。
与其他BMI组相比，超重患者在直接血管成形术治疗STEMI后预后更好。
