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May 20, 2026American Journal of Respiratory and Critical Care Medicine

C55-08 Inpatient Outcomes of Individuals Admitted for First-Time Myocardial Infarction With Preexisting Obesity: A Nationwide Analysis 2016-2022

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Key result

Preexisting obesity linked to ~25% lower in-hospital mortality odds after first-time STEMI and NSTEMI.

  • OR 0.7493 (STEMI) and OR 0.6927 (NSTEMI)
  • P=0.00
  • n=3,539,274

Why the study?

Although obesity is an independent risk factor for MI, the effect of preexisting obesity on individuals hospitalized with first-time MI remains relatively underexamined.

Does preexisting obesity reduce in-hospital mortality in patients admitted for first-time myocardial infarction?

Population

1,022,535 STEMI and 2,516,739 NSTEMI hospitalizations for first-time MI in the United States

Comparison

Preexisting obesity vs without preexisting obesity

Design

Retrospective cohort analysis

Authors

MYM YappSound Shore Medical CenterJLJ T LangleySound Shore Medical CenterMMM MandelCollege of New Rochelle

Discussion

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Implication

May support mortality benefit in large cohorts; leaves open whether this association is causal or confounded.

Key Points

  • This study aims to explore the impact of preexisting obesity on inpatient outcomes following first-time myocardial infarction (MI).
  • Retrospective cohort analysis using the National Inpatient Sample (NIS) Database (2016-2022).
  • Identified patients with first-time MI and preexisting obesity using ICD-10 codes.
  • Performed univariate and multivariate analyses adjusting for demographic and clinical variables.
  • Among 1,022,535 STEMI cases, 18.76% had preexisting obesity, showing decreased mortality odds (OR: 0.7493, p = 0.00).
  • Among 2,516,739 NSTEMI cases, 22.01% had preexisting obesity, also showing decreased mortality odds (OR: 0.6927, p = 0.00) but increased length of stay (0.2815, p = 0.00).
  • Patients with obesity had increased odds of coronary angiogram (OR: 1.1670-1.2480, p = 0.00) and CABG (OR: 1.4533-1.5529, p = 0.00).

Study Design

Type

Cohort (n=3,539,274)

Multicenter

Yes

Structured PICO

Does preexisting obesity reduce in-hospital mortality in patients admitted for first-time myocardial infarction?

P
Population
3,539,274 hospitalizations for first-time myocardial infarction (1,022,535 STEMI and 2,516,739 NSTEMI) in the United States from 2016-2022.
I
Intervention
Preexisting obesity
C
Comparator
No preexisting obesity
O
Outcome
In-hospital mortalityhard clinical

Main Result

Effect estimate: OR 0.7493 (STEMI) and OR 0.6927 (NSTEMI)

p-value: p=0.00

Patients with first-time MI and preexisting obesity have lower in-hospital mortality but higher rates of coronary angiography and CABG, reinforcing the obesity paradox.

Cite This Study

Yapp et al. (2026) conducted a cohort in First-time Myocardial Infarction (STEMI and NSTEMI) (n=3,539,274). Preexisting obesity vs. No preexisting obesity was evaluated on In-hospital mortality (OR 0.7493 (STEMI) and OR 0.6927 (NSTEMI), p=0.00). Preexisting obesity in patients with first-time MI was associated with decreased odds of in-hospital mortality for both STEMI (OR 0.7493, p=0.00) and NSTEMI (OR 0.6927, p=0.00).

synapsesocial.com/papers/6a0d50cdf03e14405aa9ceeehttps://doi.org/10.1093/ajrccm/aamag162.1548
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1OR6-8 | Obesity Paradox In Patients With Non-ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Nationwide Retrospective Observational Study2024
  2. 2Relationship Between Body Mass Index and Outcomes in Acute Myocardial Infarction2022 · 7 citations
  3. 3In Patients Presenting with an ST-Elevation Myocardial Infarction, Overweight and Obese Patients Have the Lowest Inpatient Mortality whereas Cachexia Patients Have the Highest Inpatient Mortality Followed by Patients with Morbid Obesity2024 · 2 citations
  4. 4The Impact of Elevated BMI on Outcomes of Acute Myocardial Infarction2026
  5. 5The Effects of the Obesity Paradox and In-Hospital and One-Year Outcomes in Patients With ST Elevation Myocardial Infarction (STEMI): Results From a STEMI Registry.2023