Here’s a study that shows people with high BMI’s (that’s fat) do just as well with per cutaneous intervention (cath and stents) for heart attacks.
TAKE-HOME MESSAGE
In this substudy of the HORIZONS-AMI trial, STEMI patients undergoing PCI were subdivided by BMI quartiles and then assessed based on BMI quartile for differences in risk factors and outcomes.
Patients with higher BMI had more cardiac risk factors and presented at a younger age. However, their overall outcome was similar to that of patients with lower BMI when adjusting for risk factors.
– Ashish Aggarwal, MD
ABSTRACT
The clinical outcome of acute cardiovascular events may be more favorable in patients with a high body mass index (BMI), even though obesity increases the risk for cardiovascular diseases. The authors sought to define the association between BMI and acute and long-term outcome of patients presenting within 12 hours of ST-segment myocardial infarction (STEMI) in a large multinational cohort. A total of 3,579 patients enrolled in the HORIZONS-AMI trial were stratified according to BMI quartiles: <24.5, 24.5 to 30.1 kg/m2 (quartile 1, 2, 3, and 4, respectively). Death, myocardial reinfarction, ischemia-driven target vessel revascularization, stroke, and non-coronary artery bypass grafting-related major bleeding events were centrally adjudicated for the acute, 30 days, and yearly follow-up. Patients with a BMI in the highest quartile were younger than patients in the lower BMI quartiles and more frequently had hypertension, hyperlipidemia, and diabetes mellitus. Complete occlusions and non-calcified lesions were more common in patients with a high BMI. In-hospital mortality decreased with increasing BMI due to lower cardiac mortality (2.9%, 2.3%, 1.2%, and 1.0% for quartile 1, 2, 3, and 4, respectively, p<0.05). Out-of-hospital 3-year mortality was also lower in higher-weight patients due to lower non-cardiac mortality (4.2%, 2.6%, 2.3%, and 1.7% for quartiles 1-4, respectively, p=0.01). After adjustment for covariates, BMI was no longer predictive of acute or long-term mortality after STEMI. In conclusion, as BMI increases, patients have a more extensive adjusted cardiovascular risk profile and disease burden and premature STEMI onset, but similar adjusted acute- and long-term outcomes.
The American Journal of Cardiology
Body Mass Index and Acute and Long-Term Outcomes After Acute Myocardial Infarction (From the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] Trial)
Am J Cardiol 2014 Apr 16;[EPub Ahead of Print], J Herrmann,