The Existence of Obesity Paradox and Effect of Obesity on In-Hospital-Outcomes on Elderly Patients Treated with Primary Percutaneous Coronary Intervention

Abstract

Summary: Background: Many studies have been conducted about the existence of obesity paradox in cardiovascular diseases. But, there is limited data on elderly patients. The aim of this study is to explore the existence of the “obesity paradox” and effect of obesity in periprocedural outcomes in patients presenting with acute myocardial infarction (AMI). Methods: This study involved elderly patients (≥65 years) who admitted our clinic with AMI and treated for acute STEMI between April 2011 and November 2014. Patients were divided into two groups according to their body mass index (BMI [kg/m2]) and a BMI>30 kg/m2 was accepted as obese. We compared angiographic, electrocardiographic, echocardiographic data and in-hospital mortality between two groups. Results: A total of 127 patients were included in the study and obese (BMI>30 kg/m2) patients comprised 27.3% (47) of all AMI patients. Analysis of the acute coronary angiographic data revealed that the number of significant coronary lesions was higher in non-obese group (p:0.04). The last TIMI-3 rate was higher in the obese group (%91.5 vs %79.2, p:0.05), whilst corrected TIMI frame count was lower (26 ± 13 vs 32 ± 14, p:0.01). In multivariate analysis, the number of lesions was correlated with obesity (OR 0.47, 95%CI 0.37–0.99, p:0.04). Conclusion: In our study, obesity was associated with better coronary flow after percutaneous coronary intervention and the number of lesions was lower in obese patients compared to non-obese elderly patients treated for STEMI. Our results were consistent with the phenomenon of “the obesity paradox”. Keywords: elderly, obesity paradox, myocardial infarction