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BMI, Infarct Size, and Clinical Outcomes Following Primary PCI: Patient-Level Analysis From 6 Randomized Trials.

Shahim, Bahira (författare)
Redfors, Björn (författare)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
Chen, Shmuel (författare)
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Thiele, Holger (författare)
Eitel, Ingo (författare)
Gkargkoulas, Fotis (författare)
Crowley, Aaron (författare)
Ben-Yehuda, Ori (författare)
Maehara, Akiko (författare)
Stone, Gregg W (författare)
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2020
2020
Engelska.
Ingår i: JACC. Cardiovascular interventions. - 1876-7605. ; 13:8, s. 965-972
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • The aim of this study was to examine the association between body mass index (BMI), infarct size (IS) and clinical outcomes.The association between obesity, IS, and prognosis in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction is incompletely understood.An individual patient-data pooled analysis was performed from 6 randomized trials of patients undergoing pPCI for ST-segment elevation myocardial infarction in which IS (percentage left ventricular mass) was assessed within 1 month (median 4 days) after randomization using either cardiac magnetic resonance (5 studies) or 99mTc sestamibi single-photon emission computed tomography (1 study). Patients were classified as normal weight (BMI <25 kg/m2), overweight (25 kg/m2 ≤BMI <30 kg/m2), or obese (BMI ≥30 kg/m2). The multivariable models were adjusted for age, sex, hypertension, hyperlipidemia, current smoking, left main or left anterior descending coronary artery infarct, baseline TIMI (Thrombolysis In Myocardial Infarction) flow grade 0 or 1, prior myocardial infarction, symptom-to-first device time, and study.Among 2,238 patients undergoing pPCI, 644 (29%) were normal weight, 1,008 (45%) were overweight, and 586 (26%) were obese. BMI was not significantly associated with IS, microvascular obstruction, or left ventricular ejection fraction in adjusted or unadjusted analysis. BMI was also not associated with the 1-year composite risk for death or heart failure hospitalization (adjusted hazard ratio: 1.21 [95% confidence interval: 0.74 to 1.71] for overweight vs. normal [p = 0.59]; adjusted hazard ratio: 1.21 [95% confidence interval 0.74 to 1.97] for obese vs. normal [p = 0.45]) or for death or heart failure hospitalization separately. Results were consistent when BMI was modeled as a continuous variable.In this individual patient-data pooled analysis of 2,238 patients undergoing pPCI for ST-segment elevation myocardial infarction, BMI was not associated with IS, microvascular obstruction, left ventricular ejection fraction, or 1-year rates of death or heart failure hospitalization.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Aged
Body Mass Index
Female
Heart Failure
mortality
physiopathology
therapy
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Myocardium
pathology
Obesity
diagnosis
mortality
physiopathology
Patient Readmission
Percutaneous Coronary Intervention
adverse effects
mortality
Predictive Value of Tests
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors
ST Elevation Myocardial Infarction
diagnostic imaging
mortality
physiopathology
therapy
Stroke Volume
Time Factors
Tomography
Emission-Computed
Single-Photon
Treatment Outcome
Ventricular Function
Left

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