Prognostic significance of BMI after PCI treatment in ST-elevation myocardial infarction: a cohort study from the Swedish Coronary Angiography and Angioplasty Registry
Key result
Obesity was not significantly associated with lower 1-year mortality compared to normal weight after adjustment (HR 0.88; 95% CI 0.75-1.02), whereas overweight patients had the lowest risk (HR 0.87).
Why the study?
Although obesity promotes coronary artery disease, a high BMI appears to exert a protective effect after a coronary event, a phenomenon known as the obesity paradox.
Does BMI category affect 1-year all-cause mortality in patients with STEMI undergoing PCI?
Population
25 384 patients undergoing PCI for STEMI in Sweden
Comparison
Four categories of BMI compared to normal weight
Design
Registry-based cohort study
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
No mortality benefit confirmed for obesity after adjustment; leaves open the obesity paradox and BMI-mortality link in observational data.
Study Design
Type
Cohort (n=25,384)
Multicenter
Yes
Structured PICO
Does BMI category affect 1-year all-cause mortality in patients with STEMI undergoing PCI?
P
Population
25,384 patients (mean age 67.7 years, 29.8% female) undergoing PCI for STEMI in Sweden, followed for 1 year to assess the prognostic significance of BMI.
E
Exposure
Obesity (BMI ≥30 kg/m²), overweight (BMI 25.0–29.9 kg/m²), and underweight (BMI <18.5 kg/m²)
C
Comparator
Normal weight (BMI 18.5–24.9 kg/m²)
O
Outcome
1-year all-cause mortalityhard clinical
Main Result
Hazard Ratio: 0.88 (95% CI 0.75–1.02)
p-value: p=non-significant
In STEMI patients undergoing PCI, being overweight is associated with the lowest 1-year mortality risk, while being underweight carries the highest risk, challenging the pure 'obesity paradox' after covariate adjustment.
Cite This Study
Jamaly et al. (2021) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=25,384). Obesity (BMI ≥30 kg/m2) vs. Normal weight (BMI 18.5–24.9 kg/m2) was evaluated on 1-year all-cause mortality (HR 0.88, 95% CI 0.75-1.02, p=non-significant). Obesity was not significantly associated with lower 1-year mortality compared to normal weight after adjustment (HR 0.88; 95% CI 0.75-1.02), whereas overweight patients had the lowest risk (HR 0.87).