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Cited by 98Acute Myocardial Infarction ResearchCardiovascular Function and Risk FactorsCardiac Health and Mental Health

Excess weight at time of presentation of myocardial infarction is associated with lower initial mortality risks but higher long-term risks including recurrent re-infarction and cardiac death

Nigam, Anil, Wright, R. Scott, Allison, Thomas G., Williams, Brent A., Kopecky, Stephen L., Reeder, Guy S., Murphy, Joseph G., Jaffe, Allan S.·2006·International Journal of Cardiology
DOI 10.1016/j.ijcard.2005.06.040
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Abstract

Objectives To evaluate the influence of elevated body mass index (BMI) on short- and long-term survival following acute myocardial infarction (AMI).Background Recent studies suggest an obesity survival paradox in individuals undergoing percutaneous coronary intervention with better 30-day and 1-year outcomes in obese relative to normal weight patients. We tested a similar obesity paradox hypothesis following acute myocardial infarction.Methods Short- and long-term all-cause mortality, and risk of recurrent AMI were evaluated according to BMI status in 894 consecutive survivors of AMI <80 years of age admitted to the Mayo Clinic Coronary Care Unit between January 1, 1988 and April 16, 2001. Normal weight, overweight and obesity were defined as BMI <25, 25-29.9, and >30 kg/m(2), respectively.Results Overall mortality following hospital discharge was significantly lower in overweight and obese patients and was mostly attributable to lower 6-month mortality (adjusted HR = 0.47, P = 0.01 for BMI >25 kg/m(2)) relative to normal weight patients, while long-term mortality among 6-month survivors was similar in all 3 groups. The risk of recurrent AMI was higher in patients with BMI >25 kg/m(2) (adjusted HR = 2.30, P = 0.01). Overweight and obese patients were significantly more likely to die from cardiac rather than non-cardiac causes (P < 0.01).Conclusions Following AMI, overweight and obese individuals although paradoxically protected from short-term death have a long-term mortality risk that is similar to normal weight individuals. Younger age at the time of initial infarction and fewer non-cardiovascular comorbidities presumably explain the short-lived obesity survival paradox following myocardial infarction.

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  • Overweight and obese individuals are protected from short-term death yet have a long-term mortality risk similar to normal-weight individuals.

    “One recent study has suggested that overweight and obese individuals were in fact protected from short-term death yet have a long-term mortality risk that is similar to normal-weight individuals (254).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [254]

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Authors
Nigam, A., Wright, R. S., Allison, T. G., Williams, B. A., Kopecky, S. L., Reeder, G. S., Murphy, J. G., & Jaffe, A. S.
Affiliations
Mayo Clinic (US)
Corresponding author
Wright, R. Scott
ORCID
Venue
International Journal of Cardiology
Publisher
Elsevier BV
Published
2006-06
Volume
110
Issue
2
Pages
153-159
ISSN
0167-5273 (ISSN-L)
DOI
10.1016/j.ijcard.2005.06.040
OpenAlex
W2168235472
Cited by
98
References
20
Citations by year
2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 7 · 2016: 3 · 2015: 4 · 2014: 5 · 2013: 9 · 2012: 6
FWCI
2.74
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
obesity, body mass index, acute myocardial infarction, obesity paradox, survival after myocardial infarction, all-cause mortality, reinfarction, cardiovascular mortality, overweight, long-term mortality
MeSH terms
Aged, Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Obesity, Recurrence, Retrospective Studies, Risk Factors, Time Factors, Body Mass Index, Survival Rate, Case-Control Studies, Overweight

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