scholarly journals Body Mass Index and Hospital Mortality in Patients with Acute Coronary Syndrome Receiving Care in a University Hospital

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Mercedes Camprubi ◽  
Sandra Cabrera ◽  
Jordi Sans ◽  
Georgina Vidal ◽  
Teresa Salvadó ◽  
...  

Although obesity is a well-established cardiovascular risk factor, some controversy has arisen with regard to its effect on hospital mortality in patients admitted for acute coronary syndrome.Methods. Clinical and anthropometric variables were analyzed in patients consecutively admitted for acute coronary syndrome to a university hospital between 2009 and 2010, and the correlation of those variables with hospital mortality was examined.Results. A total of 824 patients with a diagnosis of myocardial infarction or unstable angina were analyzed. Body mass index was an independent factor in hospital mortality (odds ratio 0.739 (IC 95%:0.597-0.916),P=0.006). Mortality in normal weight(n=218), overweight(n=399), and obese(n=172)subjects was 6.1%, 3.1%, and 4.1%, respectively, with no statistically significant differences between the groups.Conclusions. There is something of a paradox in the relationship between body mass index and hospital mortality in patients with acute coronary syndrome in that the mortality rate decreases as body mass index increases. However, no statistically significant differences have been found in normal weight, overweight, or obese subjects.

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim

Abstract Background The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). We investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes. Methods We identified 6978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2015. Baseline body mass index (BMI) was categorized as underweight (< 18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥ 30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results After adjustment for confounding variables, compared to normal-weight patients without diabetes (reference group), obese class I patients with and without diabetes had a lower risk of MACE, but only significant in patients without diabetes (with diabetes: hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.78–1.14; without diabetes: HR 0.78, 95% CI 0.62–0.97). Obese class II patient with diabetes had a higher risk of MACE with no statistical significance (HR 1.14, 95% CI 0.82–1.59). Underweight patients with and without diabetes had a higher risk of MACE, but only significant in patients with diabetes (with diabetes: HR 1.79, 95% CI 1.24–2.58; without diabetes: HR 1.23, 95% CI 0.77–1.97). Conclusion In ACS patients, obesity had a protective effect on CV outcomes, especially in patients without diabetes.


2020 ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim

Abstract Background: The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). Therefore, we investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes.Methods: We identified 6,978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2003 and 2015. Baseline body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results: The study included 3,989 patients with and 2,989 without diabetes. Compared to normal-weight patients without diabetes (reference group), those with diabetes had a higher risk of MACE (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.07–1.56). Obese patients without diabetes had a lower risk of MACE (HR, 0.78; 95% CI, 0.62–0.97) than those with diabetes (HR, 0.95; 95% CI 0.78–1.14). In patients without diabetes, obese BMI decreased the risk of HHF (HR, 0.62; 95% CI, 0.42–0.92) and stroke (HR, 0.61; 95% CI, 0.42–0.88), but not in those with diabetes. Conclusion: Among patients with ACS, obesity had rather protective effect on CV outcomes compared to normal weight, while this was not evident in patients with diabetes.


2020 ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim

Abstract Background: The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). We investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes.Methods: We identified 6,978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2015. Baseline body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results: After adjustment for confounding variables, compared to normal-weight patients without diabetes (reference group), obese class I patients with and without diabetes had a lower risk of MACE, but only significant in patients without diabetes (with diabetes: hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.78–1.14; without diabetes: HR 0.78, 95% CI 0.62–0.97). Obese class II patient with diabetes had a higher risk of MACE with no statistical significance (HR 1.14, 95% CI 0.82–1.59). Underweight patients with and without diabetes had a higher risk of MACE, but only significant in patients with diabetes (with diabetes: HR 1.79, 95% CI 1.24–2.58; without diabetes: HR 1.23, 95% CI 0.77–1.97).Conclusion: In ACS patients, obesity had a protective effect on CV outcomes, especially in patients without diabetes.


2021 ◽  
pp. svn-2020-000534
Author(s):  
Zhentang Cao ◽  
Xinmin Liu ◽  
Zixiao Li ◽  
Hongqiu Gu ◽  
Yingyu Jiang ◽  
...  

Background and aimObesity paradox has aroused increasing concern in recent years. However, impact of obesity on outcomes in intracerebral haemorrhage (ICH) remains unclear. This study aimed to evaluate association of body mass index (BMI) with in-hospital mortality, complications and discharge disposition in ICH.MethodsData were from 85 705 ICH enrolled in the China Stroke Center Alliance study. Patients were divided into four groups: underweight, normal weight, overweight and obese according to Asian-Pacific criteria. The primary outcome was in-hospital mortality. The secondary outcomes included non-routine discharge disposition and in-hospital complications. Discharge to graded II or III hospital, community hospital or rehabilitation facilities was considered non-routine disposition. Multivariable logistic regression analysed association of BMI with outcomes.Results82 789 patients with ICH were included in the final analysis. Underweight (OR=2.057, 95% CI 1.193 to 3.550) patients had higher odds of in-hospital mortality than those with normal weight after adjusting for covariates, but no significant difference was observed for patients who were overweight or obese. No significant association was found between BMI and non-disposition. Underweight was associated with increased odds of several complications, including pneumonia (OR 1.343, 95% CI 1.138 to 1.584), poor swallow function (OR 1.351, 95% CI 1.122 to 1.628) and urinary tract infection (OR 1.532, 95% CI 1.064 to 2.204). Moreover, obese patients had higher odds of haematoma expansion (OR 1.326, 95% CI 1.168 to 1.504), deep vein thrombosis (OR 1.506, 95% CI 1.165 to 1.947) and gastrointestinal bleeding (OR 1.257, 95% CI 1.027 to 1.539).ConclusionsIn patients with ICH, being underweight was associated with increased in-hospital mortality. Being underweight and obese can both increased risk of in-hospital complications compared with having normal weight.


Author(s):  
Nobuaki Kobayashi ◽  
Yusaku Shibata ◽  
Osamu Kurihara ◽  
Takahiro Todoroki ◽  
Masayuki Tsutsumi ◽  
...  

2019 ◽  
Vol 5 (1) ◽  
pp. 162-168
Author(s):  
Didik Rio Pambudi ◽  
Ashon Sa�adi ◽  
Sudjarwo Sudjarwo

Obesity-related to the result of decreased reproduction. Obese women are more prone to abnormal anovulation and uterine bleeding, endometrial hyperplasia/cancer, infertility, miscarriage, and pregnancy complications, compared to women of normal weight. This study aims to determine the levels of anti-Mullerian hormone (AMH) in the serum at various BMI (body mass index), also to determine the relationship and correlation between obesity and AMH levels in serum. The population in the study were women aged 20 years to 40 years with less BMI, Normal BMI and Obesity BMI. The study subjects were women between the ages of 20 to 40 years with a BMI less than 17-19.9, obesity BMI = 25 and normal BMI 20-25 as controls. Height measurement, weight weighing, and BMI calculation carried out according to the standard and subject to approval. Taking blood samples for the examination of AMH levels carried out by the RSKI laboratory (Infection Special Hospital) Airlangga University. The results of the data processed with SPSS 25 with the Shapiro-Wilk normality test and Mann Whitney statistical analysis for different tests and Spearman analysis for the correlation test. The results of the study found homogeneous samples, there were no significant differences between the AMH levels of the less and obese groups with, p = 0.832 (p> 0.05). AMH levels in BMI were less (0.459 � 0.112 ng / mL) than obesity BMI (0.432 � 0.058 ng / mL), so it was concluded that AMH levels did not correlate with less BMI with obesity BMI, with a correlation value (r) = -0.105 (p = 0.643; p> 0.05). The results of this study concluded that body mass index not related and does not correlate with the levels of anti-Mullerian hormone in the serum.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Shao-Yuan Chuang ◽  
Jonathan Jiunn-Horng Chen ◽  
Chih-Cheng Wu ◽  
Wen-Harn Pan

Few studies examine the association between serum uric acid (SUA) and acute coronary syndrome (ACS). We aimed to investigate the association between SUA and ACS in a prospective study of ethnic Chinese. Enrolled were 128569 adults ≥ 20 yrs from 4 MJ Health Checkup Clinics in Taiwan during 1994 –1996, excluding those with heart disease, stroke, renal disease and cancer disease. All physical examination, biochemical test and structured questionnaire were executed in standardized central labs. ACS was defined by main ICD-9 of 410 – 414 from claim data of National Health Insurance for hospitalization and from Death certification registry. Cox proportional hazard model was used to estimate the hazard ratios (HRs) between levels of SUA and ACS events. A total of 2049 subjects (Men: 1239/Women: 810) developed ACS during the period from baseline to Dec.31.2002. Men had higher ACS incidence than women (2.84 vs. 1.61 per 1000 person-years [PY]; p < .0001). Independent risk factors of ACS unfolded from this study included age, male sex, waist circumference, body mass index, triglycerides, total-cholesterol, hypertension, diabetes, uric acid, and current smoking. The crude incidences of ACS were 1.27, 2.06, 3.27 and 4.61 per 1000 PY in that order for four consecutive SUA groups (group1: <5.0 mg/dl; group 2: 5.0 – 6.9 mg/dl; group 3: 7.0 – 8.9 mg/dl; group 4: ≥9.0 mg/dl) (p-value for trend <.0001). Compared to group1, the multi-variate adjusted HRs (95% Confidence intervals) were 1.14 (0.92, 1.42) for group 2, 1.38 (1.10, 1.72) for group 3 and 1.38 (1.10, 1.72) for group 4 among men, and 1.03 (0.87, 1.22), 1.30 (1.05, 1.62) and 1.43 (0.99, 2.05) among women after adjusting for age, systolic/diastolic BP, body mass index, triglycerides, total cholesterol, diabetes, smoking, alcohol drinking, physical activity, and occupation. One standard deviation increase in SUA corresponded to around 30% ACS risk increase in women (HR=1.33; 1.04 –1.70) and 60% in men (HR=1.59; 1.25–2.03). Baseline SUA level independently predicts the development of ACS and should be considered as a potential risk factor of ACS.


2014 ◽  
Vol 14 (4) ◽  
pp. 271-276 ◽  
Author(s):  
Inna A. Rozumenko ◽  
Victoria Y. Garbusova ◽  
Yurij A. Ataman ◽  
Alexey V. Polonikov ◽  
Alexander V. Ataman

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