Overweight and obesity were associated with lower in-hospital mortality in STEMI patients with diabetes (adjusted OR 0.625 [95% CI 0.499-0.784] and 0.606 [95% CI 0.502-0.733], respectively).
Observational (n=74,099)
Yes
Does overweight and obesity reduce in-hospital mortality in patients with STEMI and type 2 diabetes mellitus?
A U-shaped association exists between BMI and mortality in STEMI patients with diabetes, with overweight and obese patients experiencing better in-hospital survival, demonstrating an obesity paradox.
Odds Ratio: 0.606 (95% CI 0.502–0.733)
OBJECTIVE: The relationship between obesity and in-hospital outcomes in individuals with type 2 diabetes mellitus (T2DM) who develop an ST-elevation myocardial infarction (STEMI) was assessed. METHODS: Data from the National Inpatient Sample (NIS) from 2008 to 2017 were analyzed. Patients with STEMI and T2DM were classified as being underweight or having normal weight, overweight, obesity, and severe obesity. The temporal trend of those BMI ranges and in-hospital outcomes among different obesity groups were assessed. RESULTS: A total of 74,099 patients with T2DM and STEMI were included in this analysis. In 2008, 35.8% of patients had obesity, and 37.3% had severe obesity. However, patients with obesity accounted for most of the study population in 2017 (57.8%). During the observation period, mortality decreased in underweight patients from 18.1% to 13.2% (p < 0.001). Still, it gradually increased in all other BMI ranges, along with cardiogenic shock, atrial fibrillation, and ventricular fibrillation (p < 0.001 for all). After the combination of all patients during the observation period, mortality was lower in patients with overweight and obesity (adjusted odds ratio = 0.625 95% CI 0.499-0.784; 0.606 95% CI 0.502-0.733, respectively). CONCLUSIONS: A U-shaped association governs the relationship between BMI and mortality in STEMI patients with diabetes, with those having overweight and obesity experiencing better survival.
Chaudhry et al. (Sun,) conducted a observational in ST-elevation myocardial infarction (STEMI) and type 2 diabetes mellitus (T2DM) (n=74,099). Overweight and obesity vs. Underweight or normal weight was evaluated on In-hospital mortality (OR 0.606, 95% CI 0.502-0.733). Overweight and obesity were associated with lower in-hospital mortality in STEMI patients with diabetes (adjusted OR 0.625 [95% CI 0.499-0.784] and 0.606 [95% CI 0.502-0.733], respectively).