摘要
肥胖是一个普遍存在的问题,在心血管疾病人群中尤为突出。肥胖患者在行择期经皮冠状动脉介入手术(PCI)后心血管死亡率较低;但是,缺乏在急性心肌梗死(AMI)患者中的相应资料。本研究旨在探讨体重指数(BMI)对AMI患者PCI术后结局的影响。所有患者按照BMI分为3组:正常、超重或肥胖组。大多数(70%)因AMI接受直接PCI手术的患者为超重或肥胖。与对照患者相比,肥胖患者年龄明显较轻,
Obesity is a widespread problem, particularly in the cardiovascular disease population. Obese patients have a lower incidence of cardiovascular mortality after elective percutaneous coronary interventions(PCIs); however, there is a paucity of data in the acute myocardial infarction(AMI) setting. This study investigated the effects of body mass index(BMI) on outcomes after percutaneous coronary revascularization in patients with AMI. Patients were categorized into 3 groups based on their BMI, i.e., normal, overweight, or obese. Most patients undergoing primary PCI for AMI(70% ) were overweight or obese. Obese patients were significantly younger and more often diabetic, hypertensive, and hyperlipidemic compared with other groups. Angiographically, there was no difference in presence of multivessel disease, final Thrombolysis In Myocardial Infarction grade 3 flow, and presence of thrombus or dissection. Mortality was significantly lower in the hospital at 6 and 12 months in the obese group. Multivariate analysis demonstrated age >70 years, final Thrombolysis In Myocardial Infarction grade< 3 flow, history of peripheral vascular disease, and ejection fraction to be the strongest predictors of mortality at 12 months. In conclusion, our data show that obese patients with AMI have a lower risk for in-hospital, 6-month, and 12-month mortality and cardiovascular events than patients with a normal BMI.
