Body mass index and in-hospital mortality in patients from the Register of Acute Coronary Syndromes (RESCUE)

Abstract

In Acute Myocardial Infarction (AMI), some studies show a better prognosis of obese patients (Obesity paradox). Objective: to determine the association between Body Mass Index (BMI) and in-hospital mortality in a series of non-consecutive cases admitted with AMI. Method: Four groups were established: Underweight (BMI<20 kg/m2 BSA), Normal weight (NW) (BMI: +20-25 kg/m2 BSA), Overweight (BMI: +25-30 kg/m2 BSA), and Obese (BMI: +30 kg/m2 BSA). Analyses were made on ST Elevation Myocardial Infarction (STEMI) population and on overall AMI population. Clinical variables, complications, hemodynamic status at admission and discharge were studied. Results: With respect to patients with BMI <20 kg / m2 BSA, the association with mortality in patients with STEMI was: in NW 0.22 (CI: 0.05-0.86, p: 0.001), Overweight: 0.03 (CI: 0.02-0.23, p: 0.001), and Obese 0.52 (IC: 0.11-2.4, p: 0.41); in AMI: NW 0.3 (0.1-1.18, p: 0.007), Overweight 0.05 (0.01-0.32, p: 0.001), and Obese 0.62 (0.14-2.6, p: 0.52). Conclusions: There are elements to propose an “Obesity Paradox” in patients with BMI and BMI between 20-30 kg / m2bs.