Higher body mass index at the time of acute myocardial infarction is associated with a favorable long-term prognosis (8-year follow-up)

2011 ◽  
Vol 26 (5) ◽  
pp. 495-501 ◽  
Author(s):  
Nobutaka Ikeda ◽  
Rintaro Nakajima ◽  
Makoto Utsunomiya ◽  
Masaki Hori ◽  
Hideki Itaya ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Body Mass ◽  
Long Term Prognosis

Body mass index linked to short-term and long-term all-cause mortality in patients with acute myocardial infarction

2021 ◽  
pp. postgradmedj-2020-139677
Author(s):  
Rui Yang ◽  
Wen Ma ◽  
Zi-Chen Wang ◽  
Tao Huang ◽  
Feng-Shuo Xu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Intensive Care ◽  
Body Mass ◽  
Normal Weight ◽  
Short Term ◽  
Icu Patients ◽  
Long Term Mortality

Purposes of studyThis study aimed to elucidate the relationship between obesity and short-term and long-term mortality in patients with acute myocardial infarction (AMI) by analysing the body mass index (BMI).Study designA retrospective cohort study was performed on adult intensive care unit (ICU) patients with AMI in the Medical Information Mart for Intensive Care III database. The WHO BMI classification was used in the study. The Kaplan-Meier curve was used to show the likelihood of survival in patients with AMI. The relationships of the BMI classification with short-term and long-term mortality were assessed using Cox proportional hazard regression models.ResultsThis study included 1295 ICU patients with AMI, who were divided into four groups according to the WHO BMI classification. Our results suggest that obese patients with AMI tended to be younger (p<0.001), be men (p=0.001) and have higher blood glucose and creatine kinase (p<0.001) compared with normal weight patients. In the adjusted model, compared with normal weight AMI patients, those who were overweight and obese had lower ICU risks of death HR=0.64 (95% CI 0.46 to 0.89) and 0.55 (0.38 to 0.78), respectively, inhospital risks of death (0.77 (0.56 to 1.09) and 0.61 (0.43 to 0.87)) and long-term risks of death (0.78 0.64 to 0.94) and 0.72 (0.59 to 0.89). On the other hand, underweight patients had higher risks of short-term(ICU or inhospital mortality) and long-term mortality compared with normal weight patients (HR=1.39 (95% CI 0.58 to 3.30), 1.46 (0.62 to 3.42) and 1.99 (1.15 to 3.44), respectively).ConclusionsOverweight and obesity were protective factors for the short-term and long-term risks of death in patients with AMI.

scholarly journals Association Between Fasting Hyperglycemia and New-Onset Atrial Fibrillation in Patients With Acute Myocardial Infarction and the Impact on Short- and Long-Term Prognosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Mingxing Li ◽  
Yingying Gao ◽  
Kai Guo ◽  
Zidi Wu ◽  
Yi Lao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
All Cause Mortality ◽  
Long Term Prognosis ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background: The relationship between fasting hyperglycemia (FHG) and new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI) is unclear, and whether their co-occurrence is associated with a worse in-hospital and long-term prognosis than FHG or AF alone is unknown.Objective: To explore the correlation between FHG and new-onset AF in patients with AMI, and their impact on in-hospital and long-term all-cause mortality.Methods: We performed a retrospective cohort study comprising 563 AMI patients. The patients were divided into the FHG group and the NFHG group. The incidence of new-onset AF during hospitalization was compared between the two groups and sub-groups under different Killip grades. Logistic regression was used to assess the association between FHG and new-onset AF. In-hospital mortality and long-term all-cause mortality were compared among patients with FHG, AF, and with both FHG and AF according to 10 years of follow-up information.Results: New-onset AF occurred more frequently in the FHG group than in the NFHG group (21.6 vs. 9.2%, p &lt; 0.001). This trend was observed for Killip grade I (16.6 vs. 6.5%, p = 0.002) and Grade II (17.1 vs. 6.9%, p = 0.005), but not for Killip grade III–IV (40 vs. 33.3%, p = 0.761). Logistic regression showed FHG independently correlated with new-onset AF (OR, 2.56; 95% CI, 1.53–4.30; P &lt; 0.001), and 1 mmol/L increased in fasting glucose was associated with a 5% higher rate of new-onset AF, after adjustment for traditional AF risk factors. AMI patients complicated with both fasting hyperglycemia and AF showed the highest in-hospital mortality and long-term all-cause mortality during an average of 11.2 years of follow-up. Multivariate Cox regression showed FHG combined with AF independently correlated with long-term all-cause mortality after adjustment for other traditional risk factors (OR = 3.13, 95% CI 1.64–5.96, p = 0.001), compared with the group with neither FHG nor new-onset AF.Conclusion: FHG was an independent risk factor for new-onset AF in patients with AMI. AMI patients complicated with both FHG and new-onset AF showed worse in-hospital and long-term all-cause mortality than with FHG or AF alone.

scholarly journals Implications of new-onset atrial fibrillation for in-hospital and long-term prognosis in patients with acute myocardial infarction: the CBD Bank study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W Yang ◽  
G Lip ◽  
H Li
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Independent Predictor ◽  
Cardiovascular Death ◽  
Long Term Follow Up ◽  
Long Term Prognosis ◽  
New Onset

Abstract Background Atrial fibrillation (AF) often coexists with coronary artery disease. Data on the incidence and prognostic impact of new-onset AF following acute myocardial infarction (AMI) with current optimal therapy are insufficient, especially in Asian populations. Purpose To investigate the incidence of new-onset AF following AMI and to assess its impact on in-hospital and long-term prognosis. Methods We included consecutive AMI patients between December 2012 and July 2019, and excluded those with prior known AF on presentation. New-onset AF was defined as newly detected AF during the index hospitalization following AMI. The primary outcomes comprised of all-cause death and cardiovascular death occurred during hospitalization; and all-cause death and cardiovascular death during long-term follow-up among those AMI survivors. Follow-up visits were routinely scheduled after discharge, at 1 month, 3 months, 6 months, 12 months and every 12 months thereafter. Results Of 3686 patients enrolled, new-onset AF was documented in 138 (3.7%) patients during a mean duration of hospitalization of 8.8±5.8 days. Independent risk factors of new-onset AF were age ≥75 years, left atrial diameter ≥40mm, high levels of cardiac troponin-I or high sensitive C reactive protein. During hospitalization, all-cause death occurred in 22 (15.9%) new-onset AF patients and 67 (1.9%) non-AF patients (p&lt;0.001); cardiovascular death occurred in 19 (13.8%) new-onset AF patients and 58 (1.6%) non-AF patients (p&lt;0.001). On multivariable logistic analysis, new-onset AF was an independent predictor of in-hospital all-cause death (OR 5.85, 95% CI: 3.24–10.55) and cardiovascular death (OR 5.44, 95% CI: 2.90–10.20). Apart from the in-hospital deaths, another 265 (7.7%) were lost to follow-up; thus, 3332 patients were included in the long-term follow-up analysis: 106 new-onset AF and 3226 non-AF patients. After a mean follow-up period of 1096.7±682.0 days, all-cause death occurred in 19 new-onset AF patients and 249 non-AF patients; corresponding rates were 8.08 (95% CI: 5.15–12.67) vs. 2.55 (95% CI: 2.25, 2.88) per 100 person-years, respectively (p&lt;0.001). Cardiovascular death occurred in 11 new-onset AF patients and 150 non-AF patients; corresponding rates were 4.68 (95% CI: 2.59–8.45) vs. 1.53 (95% CI: 1.31–1.80) per 100 person-years, respectively (p=0.002). After multivariable Cox adjustment, there was no significant association between new-onset AF and long-term all-cause death (HR 1.45, 95% CI: 0.90–2.35) or cardiovascular death (HR 1.21, 95% CI: 0.65–2.26). Conclusion New-onset AF following AMI was an independent predictor of increased risk of in-hospital mortality, but had no independent association with long-term death. Funding Acknowledgement Type of funding source: None

Obesity is associated with worse long-term outcomes in hypertrophic cardiomyopathy patients with acute myocardial infarction

Perfusion ◽  
2019 ◽  
Vol 35 (5) ◽  
pp. 384-392
Author(s):  
Jiaqi Yang ◽  
Liangshan Wang ◽  
Tienan Sun ◽  
Qianyun Guo ◽  
Fang Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Hypertrophic Cardiomyopathy ◽  
Body Mass ◽  
Coronary Intervention ◽  
Cardiac Events ◽  
Long Term Outcomes ◽  
Adverse Cardiac Events

Background: Hypertrophic cardiomyopathy is associated with poor prognosis. In our previous study, it has been reported that patients with acute myocardial infarction and hypertrophic cardiomyopathy exhibited worse long-term outcomes than those with acute myocardial infarction without hypertrophic cardiomyopathy and those with hypertrophic cardiomyopathy without acute myocardial infarction. In this article, we aimed to assess the impact of body mass index on the long-term outcomes of hypertrophic cardiomyopathy patients with acute myocardial infarction. Methods: Seventy-eight consecutive patients with hypertrophic cardiomyopathy and acute myocardial infarction were included. Obesity was defined as body mass index ⩾28 kg/m2 adapted to Chinese. The long-term endpoints were major adverse cardiac events and secondary endpoints, which included re-hospitalization, recurrent angina, thrombosis, bleeding, heart failure, and arrhythmias. Results: There were no differences in observed in-hospital mortality or 5-year mortality between the two groups of hypertrophic cardiomyopathy and acute myocardial infarction patients divided by body mass index. However, significantly increased incidence of re-percutaneous coronary intervention and stroke was observed in the obese group (re-percutaneous coronary intervention: 0.0% vs. 21.4%, p = 0.007; stroke: 5.6% vs. 28.6%, p = 0.042). The 5-year outcomes of major adverse cardiac events were inferior in the obese group (log-rank p = 0.020). Conclusion: Acute myocardial infarction and hypertrophic cardiomyopathy patients who were obese exhibited worse long-term outcomes than those without obesity.

P6211Efficacy of comprehensive Managed Care after Acute Myocardial Infarction (MC-AMI) in a long-term follow-up - preliminary experience of a single high-volume center

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Wita ◽  
K Wilkosz ◽  
M Wita ◽  
A Kulach ◽  
M Wybraniec ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Managed Care ◽  
Cardiac Rehabilitation ◽  
Cox Regression ◽  
Icd Implantation ◽  
Cox Regression Analysis ◽  
Long Term Prognosis

Abstract Introduction Despite substantial progress in the medical and interventional treatment of acute myocardial infarction (AMI), a long-term prognosis in MI survivors remains unsatisfactory. The Managed Care in Acute Myocardial Infarction (MC-AMI, KOS-zawal) is the first program of a comprehensive, supervised care for patients with AMI to improve long-term prognosis. It includes acute intervention, complex revascularization, cardiac rehabilitation (CR), outpatient follow-up, and prevention of SCD. Purpose To assess the effect of MC-AMI on major adverse cardiovascular and cerebrovascular events (MACCE) in 12 months follow-up. Methods In this single-center, retrospective observational study we enrolled 1211 patients, out of which 719 consented for participation in MC-AMI and compared them to 1130 subjects in the control group. After propensity score matching two groups of 529 subjects each were compared. Cox regression was performed to assess the effect of MC-AMI on clinical endpoints. Results Primarily, MC-AMI has been proved to reduce MACCE rate by 40% in a 12-month observation. Participants of MC-AMI had a higher adherence to cardiac rehabilitation (98 vs. 14%) higher rate of scheduled revascularisation (coronary artery bypass grafting: 9.8% vs. 4.9%, p<0.001; elective percutaneous coronary intervention: 3.0% vs 2.1%, p<0.05) and ICD implantation (2.8% vs. 0.6%, p<0.05) compared to control. Multivariable Cox regression analysis revealed MC-AMI participation to be inversely associated with the occurrence MACCE at 12 months (HR=0.500, 95%Cl 0.349–0.718, p<0.001). Besides, older age, diabetes mellitus, hyperlipidemia, prior PAD, previous UA, and lower LVEF were significantly associated with the primary endpoint. 12-month FU - freedom from MACCE Conclusions MC-AMI is the first program of a comprehensive in-hospital and post-discharge care for AMI patients. MC-AMI improves prognosis by increasing the rate of patients undergoing CR, complete revascularization and ICD implantation, thus reducing MACCE rate by 40% in 12 months. Participation in MC-AMI is inversely related to mortality rate, recurrent MI and heart failure related hospitalization during 12 months.

scholarly journals Impact of chronic total occlusion in non-culprit vessels on long-term survival of patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Nakazato ◽  
T Ando ◽  
T Kiko ◽  
T Shimizu ◽  
M Oikawa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chronic Total Occlusion ◽  
Total Occlusion ◽  
Term Survival ◽  
Kaplan Meier ◽  
Infarct Related Artery ◽  
Long Term Prognosis

Abstract Background Around 10% of patients with acute myocardial infarction (AMI) have chronic total occlusion (CTO) in non-infarct-related vessels, and they are known to be associated with higher mortality in acute phase. However, its impact on long-term prognosis after discharge remains unclear. Purpose The purpose of this study was to investigate the influence of presenting CTO lesion on long-term prognosis in patients with AMI. Method Consecutive 552 patients with AMI (male 78.3%, age 68±13 years), who had been discharged alive from our hospital, were analyzed. We divided the patients into two groups based on whether they had CTO lesion in a non-infarct-related artery or not: CTO + (n=49) and CTO - (n=503). Results Kaplan-Meier analysis (mean follow-up 1,424 days) revealed that all-cause mortality was significantly higher in CTO + group than in CTO - group (Figure, P&lt;0.001). Cox hazard ratio was 2.740, indicating a higher risk of all-cause death in the CTO + group (95% CI 1.606–4.651, P&lt;0.001). Conclusion Concurrent coronary CTO lesions in non-culprit arteries were associated with increased long-term mortality in patients with AMI. Figure 1 Funding Acknowledgement Type of funding source: None

Sign in / Sign up

Export Citation Format

Share Document