Key result
Overweight and obesity in STEMI patients undergoing initial PCI were associated with lower in-hospital mortality compared to healthy weight (OR 0.66, 95% CI 0.58-0.76 and OR 0.60, 95% CI 0.51-0.72).
Why the study?
It was unclear whether survival after initial PCI differs among STEMI patients with different body mass index.
Does overweight or obese BMI status reduce mortality in STEMI patients after initial PCI compared to healthy-weight status?
Meta-Analysis
Does overweight or obese BMI status reduce mortality in STEMI patients after initial PCI compared to healthy-weight status?
Odds Ratio: 0.66 (95% CI 0.58–0.76)
p-value: p=<0.001
This meta-analysis confirms the existence of an obesity paradox in STEMI patients undergoing PCI, where overweight and obese patients have lower mortality across multiple time horizons compared to healthy-weight patients.
Obesity paradox confirmed post-PCI in STEMI; reinforces observational data but leaves open whether BMI informs risk stratification.
OBJECTIVE: The aim of this study was to investigate whether there was a difference in survival after initial percutaneous coronary intervention (PCI) among ST-segment elevation myocardial infarction (STEMI) patients with different body mass index (BMI). METHODS: Literature retrieval was conducted on PubMed, Web of Science, Embase, CNKI, and Wanfang databases to obtain the published studies on the survival of STEMI patients with different BMI after initial PCI from the establishment of the database to 2022. All statistical analyses were performed using STATA16.0. RESULTS: Two hundred thirty-nine studies were retrieved, and 12 studies were eventually included. Meta-analysis showed that overweight patients [OR = 0.66, 95% CI (0.58, 0.76), p < .001] and obese patients [OR = 0.60, 95% CI (0.51, 0.72), p < .001] had lower in-hospital mortality than healthy-weight patients. Overweight patients [OR = 0.66, 95% CI (0.58, 0.74), p < .001] and obese patients [OR = 0.62, 95% CI (0.53, 0.72), p < .001] had lower short-term mortality than healthy-weight patients. In addition, overweight patients [OR = 0.63, 95% CI (0.58, 0.69), p < .001] and obese patients [OR = 0.59, 95% CI (0.52, 0.66), p < .001] also had lower long-term mortality than healthy-weight patients. There was no significant difference in in-hospital mortality [OR = 1.06, 95% CI (0.89, 1.27), p > .05], short-term mortality [OR = 1.04, 95% CI (0.89, 1.22), p > .05], and long-term mortality [OR = 1.07, 95% CI (0.95, 1.20), p > .05] between overweight and obese patients. CONCLUSION: This meta-analysis confirmed an obesity paradox in STEMI patients following PCI. The obesity paradox exists in in-hospital, short-term, and long-term conditions.
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Liu et al. (2022) conducted a meta-analysis in ST-segment elevation myocardial infarction (STEMI). Overweight and obesity vs. Healthy-weight patients was evaluated on In-hospital mortality (OR 0.66, 95% CI 0.58-0.76, p=<0.001). Overweight and obesity in STEMI patients undergoing initial PCI were associated with lower in-hospital mortality compared to healthy weight (OR 0.66, 95% CI 0.58-0.76 and OR 0.60, 95% CI 0.51-0.72).
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