Elsevier

American Heart Journal

Volume 114, Issue 6, December 1987, Pages 1334-1341
American Heart Journal

Influence of obesity on morbidity and mortality after acute myocardial infarction,☆☆

https://doi.org/10.1016/0002-8703(87)90534-5Get rights and content

Abstract

The influence of being overweight or obese on hospital and late (1 year) mortality and reinfarction was studied in 1760 patients with acute myocardial infarction. Body mass index (BMI) was used to categorize patients as normal weight (BMI < 25), overweight (BMI 25 to 30), and obese (BMI > 30). Clinical features and prognosis were compared in 658 normal weight patients, 884 overweight patients, and 218 obese patients. Complications during hospitalization and 1-year reinfarction rates following discharge were similar among the weight subsets. Hospital mortality was 13% in obese patients, similar to the 14% hospital mortality in normal weight patients, but significantly more than that in overweight patients (9%, p < 0.05). When stratified according to age, 30% of obese patients ≥65 years died in the hospital, compared to 13% of overweight patients (p < 0.001), and 17% of normal weight patients (p < 0.01). In patients less than 65 years, the obese group had a 6% mortality compared to a hospital mortality of 5% in overweight and 8% in normal weight groups (NS). In a multivariate analysis, obesity was an independent predictor of hospital death in the older, but not in the younger patient subset. One-year mortality for patients discharged from the hospital was significantly less in obese than in normal weight patients (7% vs 13%, p < 0.05), but not different from the 11% mortality rate in overweight patients. Differences in mortality disappeared when patients were age stratified. Excessive early mortality following myocardial infarction is strongly influenced by obesity in older patients, but obesity appears to have no significant influence on 1-year outcome or on early prognosis in patients younger than age 65.

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      To our knowledge, only 1 other study has reported an interaction between BMI and age. Hoit et al16 found that obesity was associated with increased hospital death in older (≥65 years old) but not younger patients. These observations conflict with those reported in our study but are likely explained by differences in the age distribution and categorization of BMI between studies.

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    Supported by National Institutes of Health Research Grant HL-17682, Ischemic Heart Disease Specialized Center of Research (SCOR) awarded by the National Heart, Lung, and Blood Institute, Bethesda, Maryland; the work reported herein was performed and supported under the United States Navy Clinical Investigation Program, Study Number 79-16-1224-00.

    ☆☆

    The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.

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