Body Mass Index and In-Hospital Management and Outcomes of Acute Myocardial Infarction

• Published in: Medicina (Kaunas, Lithuania) Vol. 57; no. 9; p. 926
• Main Authors: Patlolla, Sri Harsha, Gurumurthy, Gayathri, Sundaragiri, Pranathi R, Cheungpasitporn, Wisit, Vallabhajosyula, Saraschandra
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.09.2021; MDPI
• Subjects: acute myocardial infarction; Adult; Body Mass Index; cardiovascular risk factors; Comorbidity; Hospitals; Humans; Medical imaging; Mortality; Myocardial Infarction - epidemiology; Myocardial Infarction - therapy; Obesity; outcomes research; Overweight - complications; Overweight - epidemiology; Percutaneous Coronary Intervention; Risk Factors; Thinness - epidemiology; underweight; United States > US; cardiovascular risk factors; outcomes research; acute myocardial infarction; obesity; underweight
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina57090926

: Contemporary data on the prevalence, management and outcomes of acute myocardial infarction (AMI) in relation to body mass index (BMI) are limited. : Using the National Inpatient Sample from 2008 through 2017, we identified adult AMI hospitalizations and categorized them into underweight (BMI < 19.9 kg/m ), normal BMI and overweight/obese (BMI > 24.9 kg/m ) groups. We evaluated in-hospital mortality, utilization of cardiac procedures and resource utilization among these groups. : Among 6,089,979 admissions for AMI, 38,070 (0.6%) were underweight, 5,094,721 (83.7%) had normal BMI, and 957,188 (15.7%) were overweight or obese. Over the study period, an increase in the prevalence of AMI was observed in underweight and overweight/obese admissions. Underweight AMI admissions were, on average, older, with higher comorbidity, whereas overweight/obese admissions were younger and had lower comorbidity. In comparison to the normal BMI and overweight/obese categories, significantly lower use of coronary angiography (62.3% vs. 74.6% vs. 37.9%) and PCI (40.8% vs. 47.7% vs. 19.6%) was observed in underweight admissions (all < 0.001). The underweight category was associated with significantly higher in-hospital mortality (10.0% vs. 5.5%; OR 1.23 (95% CI 1.18-1.27), < 0.001), whereas being overweight/obese was associated with significantly lower in-hospital mortality compared to normal BMI admissions (3.1% vs. 5.5%; OR 0.73 (95% CI 0.72-0.74), < 0.001). Underweight AMI admissions had longer lengths of in-hospital stay with frequent discharges to skilled nursing facilities, while overweight/obese admissions had higher hospitalization costs. : In-hospital management and outcomes of AMI vary by BMI. Underweight status was associated with worse outcomes, whereas the obesity paradox was apparent, with better outcomes for overweight/obese admissions.