scholarly journals Body Mass Index and In-Hospital Management and Outcomes of Acute Myocardial Infarction

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 926
Author(s):  
Sri Harsha Patlolla ◽  
Gayathri Gurumurthy ◽  
Pranathi R. Sundaragiri ◽  
Wisit Cheungpasitporn ◽  
Saraschandra Vallabhajosyula
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Hospital Mortality ◽  
Body Mass ◽  
Hospital Management ◽  
Obesity Paradox ◽  
Nursing Facilities ◽  
Cardiac Procedures ◽  
Hospitalization Costs

Background and Objectives: Contemporary data on the prevalence, management and outcomes of acute myocardial infarction (AMI) in relation to body mass index (BMI) are limited. Materials and Methods: Using the National Inpatient Sample from 2008 through 2017, we identified adult AMI hospitalizations and categorized them into underweight (BMI < 19.9 kg/m2), normal BMI and overweight/obese (BMI > 24.9 kg/m2) groups. We evaluated in-hospital mortality, utilization of cardiac procedures and resource utilization among these groups. Results: Among 6,089,979 admissions for AMI, 38,070 (0.6%) were underweight, 5,094,721 (83.7%) had normal BMI, and 957,188 (15.7%) were overweight or obese. Over the study period, an increase in the prevalence of AMI was observed in underweight and overweight/obese admissions. Underweight AMI admissions were, on average, older, with higher comorbidity, whereas overweight/obese admissions were younger and had lower comorbidity. In comparison to the normal BMI and overweight/obese categories, significantly lower use of coronary angiography (62.3% vs. 74.6% vs. 37.9%) and PCI (40.8% vs. 47.7% vs. 19.6%) was observed in underweight admissions (all p < 0.001). The underweight category was associated with significantly higher in-hospital mortality (10.0% vs. 5.5%; OR 1.23 (95% CI 1.18–1.27), p < 0.001), whereas being overweight/obese was associated with significantly lower in-hospital mortality compared to normal BMI admissions (3.1% vs. 5.5%; OR 0.73 (95% CI 0.72–0.74), p < 0.001). Underweight AMI admissions had longer lengths of in-hospital stay with frequent discharges to skilled nursing facilities, while overweight/obese admissions had higher hospitalization costs. Conclusions: In-hospital management and outcomes of AMI vary by BMI. Underweight status was associated with worse outcomes, whereas the obesity paradox was apparent, with better outcomes for overweight/obese admissions.

scholarly journals 1002-82 Impact of body mass index on outcomes after primary angioplasty in acute myocardial infarction: The obesity paradox

2004 ◽  
Vol 43 (5) ◽  
pp. A244 ◽  
Author(s):  
Eugenia Nikolsky ◽  
Roxana Mehran ◽  
Alexandra J Lansky ◽  
Cindy L Grines ◽  
David A Cox ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Body Mass ◽  
Obesity Paradox ◽  
Primary Angioplasty

scholarly journals The Relationship Between Body Mass Index and In-Hospital Mortality in the Contemporary Era of an Acute Myocardial Infarction Management

2021 ◽  
Vol Volume 17 ◽  
pp. 551-559
Author(s):  
Gabby Elbaz-Greener ◽  
Guy Rozen ◽  
Shemy Carasso ◽  
Fabio Kusniec ◽  
Ibrahim Marai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Hospital Mortality ◽  
Body Mass ◽  
The Relationship

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

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D.W Kim
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Body Mass ◽  
Cardiac Death ◽  
Funding Source ◽  
Group Iii ◽  
End Point ◽  
Group I

Abstract Background 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 major cardiocerebrovascular events (MACCE) after AMI. Methods and findings Among 13,104 AMI patients registered in an Institute of Health in Korea between November 2011 and December 2015, 10,568 patients who eligible for this study were classified into 3 groups according to BMI (Group I; &lt;22 kg/m2, 22 ≤ Group II &lt;26 kg/m2, Group III; ≥26 kg/m2). The primary end point was a composite of cardiac death (CD), myocardial infarction (MI), target vessel revascularization (TVR), and cerebrovascular events at 1 year. Over the median follow-up of 12 months, the composite of primary end point occurred more frequently in the Group I patients than in the Group III patients (primary endpoint: adjusted hazard ratio [aHR], 1.290; 95% confidence interval [CI] 1.024 to 1.625, p=0.031). Especially, cardiac death in MACCE components 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 MACCE after AMI. This result suggests that higher BMI or obesity might confer a protective advantage over the life-quality after AMI. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Research of Korea Centers for Disease Control and Prevention and the Korea Health Technology R&D Project, Ministry of Health & Welfare (HI13C1527), Republic of Korea.

Abstract 14759: Burden of Intracranial Hemorrhage in Patients With Acute Myocardial Infarction in the United States, 2000-2017

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sri Harsha Patlolla ◽  
Saraschandra Vallabhajosyula
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Intracranial Hemorrhage ◽  
Temporal Trends ◽  
The United States ◽  
Circulatory Support ◽  
White Race ◽  
Hospitalization Costs

Introduction: There is a paucity of contemporary data on the burden of intracranial hemorrhage (ICH) complicating acute myocardial infarction (AMI). Methods: The National Inpatient Sample database (2000 to 2017) was used to evaluate in-hospital burden of ICH in adult (>18 years) AMI admissions. In-hospital mortality, hospitalization costs, length of stay, and measure of functional ability were the outcomes of interest. The discharge destination along with use of tracheostomy and percutaneous endoscopic gastrostomy (PEG) were used to estimate functional burden. Results: Of a total 11,622,528 AMI admissions, 23,422 (0.2%) had concomitant ICH. Compared to those without, admissions with ICH were on average older, female, of non-White race, with greater comorbidities, and higher rates of arrhythmias (all p<0.001). Female sex, non-White race, ST-segment-elevation AMI presentation, use of fibrinolytics, mechanical circulatory support and invasive mechanical ventilation were identified as individual predictors of ICH. The AMI admissions with ICH received less frequent coronary angiography (46.9% vs. 63.8%), percutaneous coronary intervention (22.7% vs. 41.8%), and coronary artery bypass grafting (5.4% vs. 9.2%) as compared to those without (all p<0.001). ICH was associated with a significantly higher in-hospital mortality (41.4% vs. 6.1%; adjusted OR 5.65 [95% CI 5.47-5.84]; p<0.001), and adjusted temporal trends showed a steady decrease in in-hospital mortality over the 18-year period (Figure 1A). AMI-ICH admissions also had longer hospital length of stay, higher hospitalization costs, and greater use of PEG (all p<0.001). In AMI-ICH survivors (N=13, 689), 81.3% had a poor functional outcome indicating severe morbidity and temporal trends revealed a slight increase over the study period (Figure 1B). Conclusions: ICH causes a substantial burden in AMI due to associated higher in-hospital mortality, resource utilization, and poor functional outcomes.

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