Abstract
Background
Obesity with its worldwide growing prevalence is an established cardiovascular risk factor with increased morbidity and mortality. However, the phenomenon, that mild to moderate obesity seems to represent a protective effect on diseases has been termed the “obesity paradox”.
Methods
We retrospectively assessed 529 patients (72.6% male, mean age 59.7 ± 12.7 years) admitted with ST-elevation myocardial infarction (STEMI). The female and male study populations were separated into four body mass index (BMI) groups: ≤ 24.9 kg/m 2 , 25.0–29.9 kg/m 2 , 30.0–34.9 kg/m 2 and ≥ 35.0 kg/m 2 . Blood samples of high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were analyzed.
Results
With increasing BMI group the rate of major adverse cardiac events (MACE) decreased in all patients (test for trend p = 0.041). No gender difference between MACE and BMI could be noticed ( p = 0.16). A higher risk for MACE was indicated in group BMI ≤ 18.5 kg/m 2 in comparison to group BMI 25.0–29.9 kg/m 2 (OR: 7.93; 95% CI: 1.75–35.89; p = 0.0091), whereas group BMI 30.0–34.9 kg/m 2 was significant associated with a lower risk in comparison to group BMI 25.0–29.9 kg/m 2 (OR: 0.65; 95% CI: 0.21–1.96; p = 0.044). An association between HDL-c ( p = 0.55) or LDL-c ( p = 0.10) and MACE could not be detected.
Conclusion
The study demonstrates that patients with STEMI and a BMI of 30.0–34.9 kg/m 2 have a decreased risk for MACE compared to patients with normal BMI. No gender related differences were indicated. An association between MACE and lipoproteins could not be detected.
Highlights
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Higher risk for MACE was shown in group BMI ≤ 24.9 kg/m 2 compared to BMI 25.0–29.9 kg/m 2 .
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The study showed no association between HDL-c ( p = 0.55) or LDL-c ( p = 0.10) and MACE.
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No gender difference between MACE and BMI could be detected ( p = 0.16).
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Introduction
Obesity is a serious public health care problem in industrialized nations with growing prevalence . In overweight patients the risk of all-cause mortality is markedly increased over all age groups in men and women . As a well-established risk factor for developing diabetes and hypertension, obesity has a substantial impact on cardiovascular diseases and mortality . Dyslipidemia is caused by obesity and especially the combination of low high-density lipoprotein cholesterol (HDL-c) and high low-density lipoprotein cholesterol (LDL-c) levels as well as elevated triglyceride levels are a predictor for cardiovascular events .
Surprisingly several previously published studies indicated, that mild obesity has a protective role in patients with obstructive lung disease, end-stage renal disease, advanced cancer as well as in several cardiovascular disorders . Thus it is discussed that even patients with acute myocardial infarction might benefit from mild obesity . In the literature there are only a few studies focusing on gender differences in the “obesity paradox” achieving inconsistent results . There are indications that overweight women may have a decreased risk for acute myocardial infarction, whereas their male counterparts have an increased risk .
The purpose of the present study was to investigate gender related differences and the influence of different biomarkers reflecting the nutritional status and body mass index (BMI) on in-hospital major adverse cardiac events (MACE) in patients with ST-elevation myocardial infarction (STEMI).
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