Influence of BMI on inducible ventricular tachycardia and mortality in patients with myocardial infarction and left ventricular dysfunction: The obesity paradox.
Int J Cardiol
; 265: 148-154, 2018 Aug 15.
Article
de En
| MEDLINE
| ID: mdl-29885681
ABSTRACT
BACKGROUND:
There is little known about the influence of obesity on ventricular electrical remodelling after myocardial infarction. The aim of our study was to assess the relationship between body mass index (BMI) and the primary outcome of inducible-VT and the secondary outcome of all-cause mortality in consecutive patients who presented with ST elevation myocardial infarction (STEMI) and LV-dysfunction (LVEFâ¯≤â¯40%). METHODS ANDRESULTS:
Consecutive patients (nâ¯=â¯380) with STEMI and LV-dysfunction (LVEFâ¯≤â¯40%) underwent electrophysiological (EP) studies for risk-stratification. Inducible-VT ≥200â¯ms cycle-length (CL) with one to four extra-stimuli (ES) was considered abnormal. Patients were classified according their body mass index (BMI) to be normal (18.5-24.9), overweight (25-29.9) or obese (>30). The primary outcome of inducible-VT occurred in 42.7%, 21.5% and 21% of normal weight, overweight and obese patients respectively (pâ¯<â¯0.001). When adjusting for ejection-fraction, hypertension and triple-vessel-disease, normal BMI remained a significant predictor for inducible-VT. All-cause mortality was higher in patients with normal weight (12.8%) when compared to overweight (3.2%) and obese (3.8%) patients (pâ¯=â¯0.002) and was mainly driven by increased cardiac-death (6.8%, 1.9% and 1.9% in normal, overweight and obese patients respectively, pâ¯=â¯0.05). After adjusting for age, EF, and hypertension, normal BMI remained a significant predictor of mortality.CONCLUSION:
In patients presenting with STEMI and LV-dysfunction, BMI appears to be a significant predictor of inducible-VT and all-cause mortality, with worse outcomes for those with normal weight, when compared to overweight or obese individuals. These findings are consistent with the obesity-paradox.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Indice de masse corporelle
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Tachycardie ventriculaire
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Dysfonction ventriculaire gauche
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Infarctus du myocarde
/
Obésité
Type d'étude:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limites:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Langue:
En
Journal:
Int J Cardiol
Année:
2018
Type de document:
Article
Pays d'affiliation:
Australie