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

Autor:	Ingremeau D; Department of Cardiology, Angers University Hospital, Angers 49933, France., Grall S; Department of Cardiology, Angers University Hospital, Angers 49933, France., Valliet F; Department of Cardiology, Saumur Hospital, Saumur 49403, France., Desprets L; Department of Cardiology, Cholet Hospital, Cholet 49300, France., Prunier F; Department of Cardiology, Angers University Hospital, Angers 49933, France., Furber A; Department of Cardiology, Angers University Hospital, Angers 49933, France., Bière L; Department of Cardiology, Angers University Hospital, Angers 49933, France.
Jazyk:	angličtina
Zdroj:	World journal of cardiology [World J Cardiol] 2020 Jan 26; Vol. 12 (1), pp. 44-54.
DOI:	10.4330/wjc.v12.i1.44
Abstrakt:	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/m², 877 (43.9%) had a BMI between 25 and 30 kg/m² and 416 (20.8%) had a BMI ≥ 30 kg/m². One-year cardiovascular mortality was lower for BMI ≥ 25 kg/m² (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/m² (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. Competing Interests: Conflict-of-interest statement: The authors have no conflict of interest to disclose. (©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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