Sia, CH;
Ko, J;
Zheng, H;
Ho, AFW;
Foo, D;
Foo, LL;
Lim, PZY;
... Hausenloy, DJ; + view all
(2023)
Association of body mass index, metabolic health status and clinical outcomes in acute myocardial infarction patients: a national registry-based study.
Frontiers in Cardiovascular Medicine
, 10
, Article 1142078. 10.3389/fcvm.2023.1142078.
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Abstract
INTRODUCTION: Obesity is an important risk factor for acute myocardial infarction (AMI), but the interplay between metabolic health and obesity on AMI mortality has been controversial. In this study, we aimed to elucidate the risk of short- and long-term all-cause mortality by obesity and metabolic health in AMI patients using data from a multi-ethnic national AMI registry. METHODS: A total of 73,382 AMI patients from the national Singapore Myocardial Infarction Registry (SMIR) were included. These patients were classified into four groups based on the presence or absence of metabolic diseases, diabetes mellitus, hyperlipidaemia, and hypertension, and obesity: (1) metabolically-healthy-normal-weight (MHN); (2) metabolically-healthy-obese (MHO); (3) metabolically-unhealthy-normal-weight (MUN); and (4) metabolically-unhealthy-obese (MUO). RESULTS: MHO patients had reduced unadjusted risk of all-cause in-hospital, 30-day, 1-year, 2-year, and 5-year mortality following the initial MI event. However, after adjusting for potential confounders, the protective effect from MHO on post-AMI mortality was lost. Furthermore, there was no reduced risk of recurrent MI or stroke within 1-year from onset of AMI by the MHO status. However, the risk of 1-year mortality was higher in female and Malay AMI patients with MHO compared to MHN even after adjusting for confounders. CONCLUSION: In AMI patients with or without metabolic diseases, the presence of obesity did not affect mortality. The exception to this finding were female and Malay MHO who had worse long-term AMI mortality outcomes when compared to MHN suggesting that the presence of obesity in female and Malay patients may confer worsened outcomes.
| Type: | Article |
|---|---|
| Title: | Association of body mass index, metabolic health status and clinical outcomes in acute myocardial infarction patients: a national registry-based study |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fcvm.2023.1142078 |
| Publisher version: | https://doi.org/10.3389/fcvm.2023.1142078 |
| Language: | English |
| Additional information: | © 2023 Sia, Ko, Zheng, Ho, Foo, Foo, Lim, Liew, Chai, Yeo, Yip, Chua, Chan, Tan, Bulluck and Hausenloy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | AMI mortality, AMI prognosis, MHO paradox, acute myocardial infarction, cardiovascular risk, metabolically healthy obesity (MHO), metabolism, obesity paradox |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10174213 |
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