Impact of Body Weight and Extreme Obesity on the Presentation, Treatment, and In-Hospital Outcomes of 50,149 Patients With ST-Segment Elevation Myocardial Infarction
Key result
Extreme obesity in STEMI linked to ~64% higher in-hospital mortality versus class I obesity.
- adjusted OR 1.64
- 95% CI 1.32 to 2.03
- n=50,149
Why the study?
Little is known about the impact of extreme obesity on STEMI presentation, treatments, complication rates, and outcomes despite its rapidly increasing prevalence.
Population
50,149 patients with STEMI from the NCDR ACTION Registry–GWTG
Comparison
BMI categories including extreme (class III) obesity versus other BMI groups
Design
Observational registry-based study
Follow-up
In-hospital
Authors
Discussion
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Implication
Observational registry study reveals altered clinical presentation and adverse hospital outcomes across body mass categories in myocardial infarction, highlighting obesity-related cardiovascular risk.
Key Points
- To assess how variations in body weight and extreme obesity influence clinical characteristics, treatment patterns, and in-hospital mortality among patients presenting with acute ST-segment elevation myocardial infarction.
- Analyzed clinical registry data from 50,149 patients presenting with acute ST-segment elevation myocardial infarction across multiple participating hospitals.
- Categorized patients by body mass index classes, ranging from underweight to class III extreme obesity.
- Evaluated differences in baseline characteristics, reperfusion therapy delivery, procedural complications, and multivariable-adjusted in-hospital mortality.
- Extremely obese patients presented with acute myocardial infarction at a markedly younger age and with higher rates of comorbid diabetes and hypertension compared to normal-weight peers.
- Unadjusted in-hospital mortality followed a non-linear pattern across body weight groups, with the lowest crude mortality observed among overweight and mildly obese cohorts.
- Extreme obesity was associated with heightened risks of in-hospital adverse events and post-infarction complications after adjustment for baseline age and clinical covariates.
Study Design
Type
Observational (n=50,149)
Multicenter
Yes
PICO
P
Population
50,149 patients with ST-segment elevation myocardial infarction from a national registry, assessed for in-hospital outcomes based on BMI category.
E
Exposure / Comparator
Extreme (class III) obesity (BMI ≥40 kg/m2) vs Class I obesity (30 kg/m2 ≤ BMI <35 kg/m2)
O
Primary Outcome
Risk-adjusted in-hospital mortality — adjusted OR 1.64 (1.32 to 2.03)
Main Result
Odds Ratio: 1.64 (95% CI 1.32–2.03)
Cite This Study
Das et al. (2011) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=50,149). Extreme (class III) obesity (BMI ≥40 kg/m2) vs. Class I obesity (30 kg/m2 ≤ BMI <35 kg/m2) was evaluated on Risk-adjusted in-hospital mortality (adjusted OR 1.64, 95% CI 1.32 to 2.03). In patients with STEMI, extreme obesity (BMI ≥40 kg/m2) was independently associated with higher in-hospital mortality compared to class I obesity (adjusted OR 1.64; 95% CI 1.32-2.03).