Prognostic impact of body mass index on in-hospital bleeding complications after ST-segment elevation myocardial infarction

Alain Furber; Delphine Ingremeau; Fabrice Prunier; Florine Valliet; Laurent Desprets; Loic Bière; Sylvain Grall

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Prognostic impact of body mass index on in-hospital bleeding complications after ST-segment elevation myocardial infarction

Prognostic impact of body mass index on in-hospital bleeding complications after ST-segment elevation myocardial infarction

作者：

Alain Furber Delphine Ingremeau Fabrice Prunier Florine Valliet Laurent Desprets Loic Bière Sylvain Grall

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Myocardial

INFARCTION

Body

mass

index

BLEEDING

COMPLICATIONS

Obesity

PARADOX

摘要：

BACKGROUND ST-elevation myocardial infarction(STEMI)remains a major cause of mortality despite early revascularization and optimal medical therapy.Tailoring individual management by considering patients’specificities may help in improving post-STEMI survival.AIM To evaluate whether in-hospital bleeding complications may be involved in post STEMI prognosis among overweight patients.METHODS We prospectively included 2070 patients with a STEMI between January 2005 and December 2012 in the French observational cohort,“Registre d’Infarctus Maine-Anjou”.Bleeding Academic Research Consortium(BARC)in-hospital bleeding complications were recorded.RESULTS Of 705 patients(35.3%)were presented as being of normal weight,defined as a body mass index(BMI)<25 kg/m^2,877(43.9%)had a BMI between 25 and 30 kg/m^2and 416(20.8%)had a BMI≥30 kg/m^2.One-year cardiovascular mortality was lower for BMI≥25 kg/m^2(5.3%and 7.1%)patients than for normal weight patients(10.8%)(P=0.001).We found an interaction between the effect of BARC 3 on mortality and BMI groups.While a BARC 3 was related to a higher 1-year mortality in general(HR:2.58,95%CI:1.44-4.64,P≤0.001),prognosis was even worse in normal weight patients(HR:2.97,95%CI:1.61-5.5,P<0.001)than for patients with a BMI≥25 kg/m^2(HR:1.94,95%CI:1.02-3.69,P=0.041).CONCLUSION Normal weight patients presented higher rates of in-hospital bleeding complications and lower survival after a STEMI.Excess mortality might be due to greater vulnerability to bleeding amongst normal weight patients.

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世界心脏病学杂志：英文版（电子版）2021 世界心脏病学杂志：英文版（电子版）2020 世界心脏病学杂志：英文版（电子版）2019

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篇名	Prognostic impact of body mass index on in-hospital bleeding complications after ST-segment elevation myocardial infarction
来源期刊	世界心脏病学杂志:英文版(电子版)	学科	医学
关键词	Myocardial INFARCTION Body mass index BLEEDING COMPLICATIONS Obesity PARADOX
年，卷（期）	2020,（1）	所属期刊栏目
研究方向		页码范围	44-54
页数	11页	分类号	R54
字数		语种
DOI