超重对接受直接经皮冠状动脉介入治疗患者心肌梗死面积的影响：一项磁共振成像研究。
Impact of overweight on myocardial infarct size in patients undergoing primary percutaneous coronary intervention: a magnetic resonance imaging study.
作者信息
Sohn Gwan Hyeop, Kim Eun Kyoung, Hahn Joo-Yong, Song Young Bin, Yang Jeong Hoon, Chang Sung-A, Lee Sang-Chol, Choe Yeon Hyeon, Choi Seung-Hyuk, Choi Jin-Ho, Lee Sang Hoon, Oh Jae K, Gwon Hyeon-Cheol
机构信息
Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
出版信息
Atherosclerosis. 2014 Aug;235(2):570-5. doi: 10.1016/j.atherosclerosis.2014.05.961. Epub 2014 Jun 11.
OBJECTIVE
Although obesity is a risk factor for cardiovascular disease and mortality, several studies have reported that patients with obesity who have suffered acute myocardial infarction or have undergone percutaneous coronary intervention (PCI) have better clinical outcomes than their normal weight counterparts. We evaluated the impact of overweight on myocardial infarct size in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI).
METHODS
We performed contrast-enhanced magnetic resonance imaging on 193 patients undergoing primary PCI for STEMI. Infarct size was measured with delayed-enhancement imaging and the area at risk was quantified on T2-weighted images.
RESULTS
Baseline characteristics and angiographic findings were not significantly different between the normal weight group (body mass index [BMI] < 25 kg/m(2), n = 110) and the overweight group (BMI ≥ 25 kg/m(2), n = 83). The median percent infarct volume and area at risk were significantly smaller in the overweight group than the normal weight group (17.9% [9.0-24.9%] vs. 20.8% [11.4-33.1%], p = 0.04 and 29.4% [20.5-37.6%] vs. 36.0% [25.7-49.6%], p < 0.01, respectively). However, the myocardial salvage index was not different between the 2 groups (overweight group vs. normal weight group, 43.2% vs. 39.2%, p = 0.69). BMI ≥ 25 kg/m(2) was an independent predictor of smaller infarct size in multivariate analysis (Odds ratio 0.51, 95% Confidence interval 0.27-0.97, p = 0.039).
CONCLUSION
Overweight (BMI ≥ 25 kg/m(2)) is independently associated with smaller infarct size in patients undergoing primary PCI for STEMI.
目的
尽管肥胖是心血管疾病和死亡的危险因素，但多项研究报告称，患有急性心肌梗死或接受过经皮冠状动脉介入治疗（PCI）的肥胖患者的临床结局优于体重正常的患者。我们评估了超重对接受ST段抬高型心肌梗死（STEMI）直接PCI治疗患者心肌梗死面积的影响。
方法
我们对193例接受STEMI直接PCI治疗的患者进行了对比增强磁共振成像。通过延迟强化成像测量梗死面积，并在T2加权图像上对危险区域进行量化。
结果
正常体重组（体重指数[BMI]<25kg/m²，n=110）和超重组（BMI≥25kg/m²，n=83）的基线特征和血管造影结果无显著差异。超重组的梗死体积中位数百分比和危险区域明显小于正常体重组（分别为17.9%[9.0-24.9%]对20.8%[11.4-33.1%]，p=0.04；29.4%[20.5-37.6%]对36.0%[25.7-49.6%]，p<0.01）。然而，两组之间的心肌挽救指数无差异（超重组对正常体重组，43.2%对39.2%，p=0.69）。在多变量分析中，BMI≥25kg/m²是梗死面积较小的独立预测因素（比值比0.51，95%置信区间0.27-0.97，p=0.039）。
结论
超重（BMI≥25kg/m²）与接受STEMI直接PCI治疗患者梗死面积较小独立相关。
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