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体重指数与急性心肌梗死后 1 年结局的关系。

Association between body mass index and 1-year outcome after acute myocardial infarction.

机构信息

The Catholic University of Korea, Daejeon St. Mary's Hospital, Seoul, Republic of Korea.

The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea.

出版信息

PLoS One. 2019 Jun 14;14(6):e0217525. doi: 10.1371/journal.pone.0217525. eCollection 2019.

Abstract

OBJECTIVES

Beneficial effects of overweight and obesity on mortality after acute myocardial infarction (AMI) have been described as "Body Mass Index (BMI) paradox". However, the effects of BMI is still on debate. We analyzed the association between BMI and 1-year clinical outcomes after AMI.

METHODS

Among 13,104 AMI patients registered in Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) between November 2011 and December 2015, 10,568 patients who eligible for this study were classified into 3 groups according to BMI (Group 1; < 22 kg/m2, 22 ≤ Group 2 < 26 kg/m2, Group 3; ≥ 26 kg/m2). The primary end point was all cause death at 1 year.

RESULTS

Over the median follow-up of 12 months, the event of primary end point occurred more frequently in the Group 1 patients than in the Group 3 patients (primary endpoint: adjusted hazard ratio [aHR], 1.537; 95% confidence interval [CI] 1.177 to 2.007, p = 0.002). Especially, cardiac death played a major role in this effect (aHR, 1.548; 95% confidence interval [CI] 1.128 to 2.124, p = 0.007).

CONCLUSIONS

Higher BMI appeared to be good prognostic factor on 1-year all cause death after AMI. This result suggests that higher BMI or obesity might confer a protective advantage over the life-quality after AMI.

摘要

目的

超重和肥胖对急性心肌梗死(AMI)后死亡率的有益影响被描述为“体重指数(BMI)悖论”。然而,BMI 的影响仍存在争议。我们分析了 BMI 与 AMI 后 1 年临床结局之间的关系。

方法

在 2011 年 11 月至 2015 年 12 月期间在韩国急性心肌梗死注册研究-国立卫生研究院(KAMIR-NIH)中登记的 13104 例 AMI 患者中,符合本研究条件的 10568 例患者根据 BMI 分为 3 组(组 1;<22kg/m2,22≤组 2<26kg/m2,组 3;≥26kg/m2)。主要终点为 1 年内全因死亡。

结果

在中位随访 12 个月期间,组 1患者的主要终点事件发生率高于组 3患者(主要终点:调整后的危险比[aHR],1.537;95%置信区间[CI],1.177 至 2.007,p=0.002)。特别是,心脏死亡在这种影响中起主要作用(aHR,1.548;95%置信区间[CI],1.128 至 2.124,p=0.007)。

结论

较高的 BMI 似乎是 AMI 后 1 年全因死亡的良好预后因素。这一结果表明,较高的 BMI 或肥胖可能在 AMI 后对生活质量产生保护作用。

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