Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Internal Medicine, Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2024 Mar 1;14(1):365. doi: 10.1038/s41598-023-43493-0.
Body mass index (BMI), as an important risk factor related to metabolic disease. However, in some studies higher BMI was emphasized as a beneficial factor in the clinical course of patients after acute myocardial infarction (AMI) in a concept known as the "BMI paradox." The purpose of this study was to investigate how clinical outcomes of patients treated for AMI differed according to BMI levels. A total of 10,566 patients in the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) from May 2010 to June 2015 were divided into three BMI groups (group 1: BMI < 22 kg/m, group 2: ≥ 22 and < 26 kg/m, and group 3: ≥ 26 kg/m). The primary outcome was major adverse cardiac and cerebrovascular event (MACCE) at 3 years of follow-up. At 1 year of follow-up, the incidence of MACCE in group 1 was 10.1% of that in group 3, with a hazard ratio (HR) of 2.27, and 6.5% in group 2, with an HR of 1.415. This tendency continued up to 3 years of follow-up. The study demonstrated that lower incidence of MACCE in the high BMI group of Asians during the 3-year follow-up period compared to the low BMI group. The results implied higher BMI could exert a positive effect on the long-term clinical outcomes of patients with AMI undergoing percutaneous coronary intervention (PCI).
体重指数（BMI）作为与代谢疾病相关的重要危险因素。然而，在一些研究中，较高的 BMI 被强调为急性心肌梗死（AMI）后患者临床病程中的有益因素，这一概念被称为“BMI 悖论”。本研究旨在探讨接受 AMI 治疗的患者的临床结局根据 BMI 水平的不同而有所差异。2010 年 5 月至 2015 年 6 月，韩国急性心肌梗死登记处-美国国立卫生研究院（KAMIR-NIH）共纳入 10566 例患者，根据 BMI 将患者分为三组：BMI<22kg/m组（第 1 组）、BMI≥22kg/m且<26kg/m组（第 2 组）和 BMI≥26kg/m组（第 3 组）。主要终点为 3 年随访时的主要不良心脑血管事件（MACCE）。在 1 年随访时，第 1 组的 MACCE 发生率为第 3 组的 10.1%，风险比（HR）为 2.27；第 2 组的 MACCE 发生率为 6.5%，HR 为 1.415。这种趋势持续到 3 年随访期。该研究表明，在 3 年随访期间，亚洲人群中较高 BMI 组的 MACCE 发生率低于较低 BMI 组。研究结果提示，较高的 BMI 可能对接受经皮冠状动脉介入治疗（PCI）的 AMI 患者的长期临床结局产生积极影响。
