Clinical investigations: acute ischemic heart diseaseObesity and the risk of death after acute myocardial infarction☆
Section snippets
Methods
The Onset Study was conducted in 45 community hospitals and tertiary care medical centers in the United States. Between August 1989 and September 1994, 1935 patients (601 women and 1334 men) were interviewed at a median of 4 days after having an acute MI. Trained research interviewers identified eligible patients by reviewing coronary care unit admission logs and patient charts. Thus, our study does not include patients who died before hospitalization or did not go to a hospital with their
Results
The characteristics of the Onset Study participants have been previously reported.8Table Ishows characteristics of the patient population according to BMI category. The mean BMI ranged from 22.7 kg/m2 in patients in the normal weight category to 39.3 kg/m2 in obesity class II or higher. Higher BMI was associated with younger age, diabetes, and hypertension. Minorities also tended to be more likely to be obese (P = .07). Sex, abstention from alcohol, and presence of noncardiac comorbidities were
Discussion
In this multicenter, prospective study of early survivors of acute MI followed for an average of 3.8 years, we found that BMI had a positive, graded relation with post-MI death of borderline statistical significance. The association was most apparent among patients free of major noncardiac comorbid conditions at baseline. This association remained essentially similar after adjustment for sociodemographic and clinical characteristics.
Recent data from the 1999 to 2000 National Health and
References (26)
- et al.
Predictors of subsequent coronary events, stroke, and death among survivors of first hospitalized myocardial infarction
J Clin Epidemiol
(2002) - et al.
Influence of obesity on morbidity and mortality after acute myocardial infarction
Am Heart J
(1987) - et al.
Recent aspirin use is associated with smaller myocardial infarct size and lower likelihood of Q-wave infarction
Am Heart J
(1999) - et al.
Body mass index and the risk of recurrent coronary events following acute myocardial infarction
Am J Cardiol
(2001) - et al.
Long-term changes in exercise capacity, quality of life, body anthropometry, and lipid profiles after a cardiac rehabilitation program in obese patients with coronary heart disease
Am J Cardiol
(2003) - et al.
Annual deaths attributable to obesity in the United States
JAMA
(1999) - et al.
Fifteen-year trends in cardiovascular risk factors (1980–1982 through 1995–1997)the Minnesota Heart Survey
Am J Epidemiol
(2002) - et al.
Years of life lost due to obesity
JAMA
(2003) - Solomon CG, Manson JE. Obesity and mortality: a review of the epidemiologic data. Am J Clin Nutr 1997;66(Suppl...
- Meyer HE, Sogaard AJ, Tverdal A, et al. Body mass index and mortality: the influence of physical activity and smoking....
Prior alcohol consumption and mortality following acute myocardial infarction
JAMA
Report of a WHO consultation on obesity. Obesitypreventing and managing the global epidemic
Cited by (53)
Sex-specific differences in mortality and the obesity paradox of patients with myocardial infarction ages >70 y
2018, NutritionCitation Excerpt :Additionally, results from the present study emphasized a pronounced obesity paradox in female MI patients, especially in higher obesity classes (≥II), a phenomenon that was not similarly described previously. In contrast to our findings, some studies could not confirm lower mortality in obese patients with CAD or MI [42–44]. There are several explanations for the obesity paradox.
The impact of National Death Index linkages on population-based cancer survival rates in the United States
2013, Cancer EpidemiologyCitation Excerpt :Cancer registries are encouraged to link their incidence records with both state death records and the NDI for the purpose of ascertaining deaths and updating date and cause of death information [9]. Record linkage with the NDI has been used with both adult and pediatric cohort studies [12–17]. The present study uses secondary data from the Accuracy of Cancer Mortality Statistics Based on Death Certificates (ACM) study [18].
New insights into the true nature of the obesity paradox and the lower cardiovascular risk
2013, Journal of the American Society of HypertensionA new risk score predicting 1- and 5-year mortality following acute myocardial infarction: Soroka Acute Myocardial Infarction (SAMI) Project
2012, International Journal of Cardiology
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Supported by grant HL-41016 (for the Determinants of Myocardial Infarction Onset Study) from the National Heart, Lung, and Blood Institute, Bethesda, Md, grant T32-HL07374-22 from the National Institutes of Health, Bethesda, Md, and grant 9630115N from the American Heart Association, Dallas, Tex.