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 ◽  
...  

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.

Angiology ◽  
2018 ◽  
Vol 69 (10) ◽  
pp. 900-908 ◽  
Author(s):  
Fang Liu ◽  
Yue Ma ◽  
Hailong Ge ◽  
Yingxin Zhao ◽  
Hua Shen ◽  
...  

Hypertrophic cardiomyopathy (HCM) is associated with poor prognosis. It has been reported that there is no difference in in-hospital mortality after acute myocardial infarction (AMI) between patients with and without HCM. However, whether there are differences in long-term outcomes after AMI between patients with and without HCM remains unclear. In this study, we analyzed the clinical profiles of 78 consecutive patients with HCM and AMI (HCM and AMI group), 78 sex- and age-matched patients with AMI and without HCM (AMI group), and 78 sex- and age-matched patients with HCM and without AMI (HCM group). The study end points were major adverse cardiac events (MACEs) and secondary end points. During the follow-up period of 4.8 ± 3.6 years, MACEs occurred in 19 (27.9) patients in the HCM and AMI group, in 11 (16.7%) patients in the AMI group, and in 8 (12.3%) patients in the HCM group. The long-term outcomes of the HCM and AMI group were inferior to that of the other 2 groups (log-rank P = .030 for MACEs, log-rank P = .032 for secondary end points). In conclusion, patients with AMI with HCM exhibited worse long-term outcomes than did patients with AMI without HCM and patients with HCM without AMI.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Anggoro Budi Hartopo ◽  
Dyah Samti Mayasari ◽  
Ira Puspitawati ◽  
Hasanah Mumpuni

Introduction. Platelet-derived microparticles (PDMPs) measurement adds prognostic implication for ST-elevation acute myocardial infarction (STEMI). The long-term implication of PDMPs in STEMI needs to be corroborated. Methods. The research design was a cohort study. Subjects were STEMI patients and were enrolled consecutively. The PDMPs were defined as microparticles bearing CD41(+) and CD62P(+) markers detected with flow cytometry. The PDMPs were measured on hospital admission and 30 days after discharge. The outcomes were major adverse cardiac events (MACE), i.e., a composite of cardiac death, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia, occurring from hospitalization until 1 year after discharge. Results. We enrolled 101 subjects with STEMI. During hospitalization, 17 subjects (16.8%) developed MACE. The PDMPs were not different between subjects with MACE and those without (median (IQR): 3305.0/μL (2370.0–14690.5/μL) vs. 4452.0/μL (2024.3–14396.8/μL), p=0.874). Forty-five subjects had increased PDMPs in 30 days after discharge as compared with on-admission measurement. Subjects with increased PDMPs had significantly higher 30-day MACE as compared to subjects with decreased PDMPs 17 (37.8%) vs. 6 (16.7%, p=0.036). There was a trend toward higher MACE in subjects with increased PDMPs as compared to those with decreased PDMPs in 90 days after discharge (48.9% vs. 30.6%, p=0.095) and 1 year after discharge (48.9% vs. 36.1%, p=0.249). Conclusion. The PDMPs level was increased from the day of admission to 30 days after discharge in patients with STEMI. The persistent increase in the PDMPs level in 30 days after the STEMI event was associated with the 30-day postdischarge MACE and trended toward increased MACE during the 90-day and 1-year follow-up.


2020 ◽  
Vol 35 (12) ◽  
pp. 1657-1663 ◽  
Author(s):  
Hisanori Yui ◽  
Soichiro Ebisawa ◽  
Takashi Miura ◽  
Chie Nakamura ◽  
Shusaku Maruyama ◽  
...  

Abstract Little is known about the impact of changes in body mass index (BMI) after the percutaneous coronary intervention (PCI) on long-term outcomes in patients with coronary artery disease (CAD). Therefore, this study aimed to clarify this issue. We investigated data on CAD obtained from the SHINANO Registry, a prospective, observational, multicenter cohort study, from 2012 to 2013 in Nagano, Japan. One year after PCI, the enrolled patients were divided into the following three groups based on changes in BMI by tertiles: reduced, maintained, and elevated BMI. The associations among the groups and the 4-year outcomes [major adverse cardiac events (MACEs), all-cause death, Q-wave myocardial infarction, and stroke] were examined. Five hundred seventy-two patients were divided into the reduced, maintained, and elevated BMI groups. Over the 4-year follow-up period, the cumulative incidence of MACEs was 10.5% (60 cases). In the Kaplan–Meier analysis, the incidence rates of MACE were significantly higher in the reduced BMI group than in the maintained and elevated BMI groups [17.7% versus (vs.) 7.3% vs. 9.0%, p = 0.004]. Multivariable cox regression analysis showed that the reduced group showed increased risks of MACEs (hazard ratio 2.15; 95% confidence interval 1.29–3.57; p = 0.003). The long-term clinical outcomes of patients with CAD who underwent PCI were affected by the reduction in BMI after PCI. Furthermore, the elevation of BMI after PCI was not a poor prognostic factor.


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