Does being overweight reduce all-cause mortality at 30 days in patients with AMI supported with ECMO?
An 'obesity paradox' was observed in patients with AMI supported by ECMO, where overweight patients had significantly lower 30-day mortality compared to normal-weight patients.
BACKGROUND: Previous studies have reported a "body mass index (BMI) paradox" with acute myocardial infarction (AMI), whereby overweight patients are associated with lower mortality. The aim of this study was to evaluate the impact of BMI on survival of patients with AMI supported with extracorporeal membrane oxygenation (ECMO). METHODS: , n = 33). The composite outcome was all-cause mortality at 30 days. RESULTS: The overweight group was significantly younger than the normal weight group, and there was a statistically significant difference between the two groups in electrocardiography before ECMO. Ventricular tachycardia or fibrillation occurred in 11 (33.3%) overweight patients, and asystole or pulseless electrical activity occurred in 10 (37%) normal weight patients. More of the normal weight group had successful percutaneous coronary interventions than the overweight group. The overweight group was significantly associated with lower mortality hazard ratio (HR): 0.491; 95% confidence interval (CI) = 0.267-0.903 at 30 days, which persisted after multivariate adjustments (HR: 0.442; 95% CI = 0.210-0.928). To determine predictive factors for mortality, multivariate logistic analysis revealed that overweight odds ratio (OR) 0.102; 95% CI (0.018-0.564); p = 0.009 and ECMO under cardiopulmonary resuscitation OR 19.009; 95% CI (2.139-168.956); p = 0.008 were significantly associated with all-cause mortality at 30 days. CONCLUSIONS: Overweight was associated with lower mortality in AMI patients supported with ECMO.
Lee et al. (2020) studied this question.