Diabetes, Metabolic Syndrome and Obesity (Jul 2022)

Impact of Obesity on Microvascular Obstruction and Area at Risk in Patients After ST-Segment-Elevation Myocardial Infarction: A Magnetic Resonance Imaging Study

  • Lan DH,
  • Zhang Y,
  • Hua B,
  • Li JS,
  • He Y,
  • Chen H,
  • Li WP,
  • Li HW

Journal volume & issue
Vol. Volume 15
pp. 2207 – 2216

Abstract

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Di-Hui Lan,1 Yue Zhang,1 Bing Hua,1 Jin-Shui Li,2 Yi He,2 Hui Chen,1 Wei-Ping Li,1,3 Hong-Wei Li1,3 1Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, People’s Republic of ChinaCorrespondence: Wei-Ping Li; Hong-Wei Li, Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, People’s Republic of China, Email [email protected]; [email protected]: Better survival for overweight and obese patients after ST-segment elevation myocardial infarction (STEMI) has been demonstrated. The association between body mass index (BMI), microvascular obstruction (MVO), and area at risk (AAR) after STEMI was evaluated.Methods: A prospective observational study was performed to enrolled patients undergoing primary percutaneous coronary intervention (pPCI) for STEMI and cardiac magnetic resonance was performed within 5– 7 days. Patients were classified as normal weight (18.5 ≤BMI < 24.0 kg/m2), overweight (24.0 ≤BMI < 28.0 kg/m2), or obese (BMI ≥ 28 kg/m2).Results: Among 225 patients undergoing pPCI, 67 (30.00%) were normal weight, 113 (50.22%) were overweight, and 45 (20.00%) were obese. BMI ≥ 28 kg/m2 was significantly associated with less risk of MVO when compared with a normal BMI after multivariable adjustment (overweight: HR 0.29, 95% CI 0.13– 0.68, p = 0.004). Compared with normal weight patients, obese and overweight patients tend to have larger hearts (greater left ventricular end-diastolic volume [LVEDV] and left ventricular [LV] mass). In adjusted analysis, increased BMI was significantly associated with a smaller AAR. In addition, obese patients had a smaller AAR (β = − 0.252, 95% CI − 20.298- − 3.244, p = 0.007) and AAR, % LV mass (β = − 0.331, 95% CI − 0.211- − 0.062, p < 0.001) than normal weight patients.Conclusion: Obesity (BMI ≥ 28 kg/m2) is independently associated with lower risks of MVO and a smaller AAR, % LV mass than normal weight patients among subjects undergoing pPCI for STEMI.Keywords: ST-segment elevation myocardial infarction, STEMI, microvascular obstruction, MVO, cardiac magnetic resonance, CMR, body mass index, BMI, area at risk, AAR

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