Body mass index and myocardium at risk in patients with acute coronary syndrome

Abstract

Background and objectives: Whilst traditional studies have shown that obese individuals are at a higher risk of cardiovascular events compared to lean subjects, recent studies in patients with acute myocardial infarction (AMI) have suggested that obesity may exert protective effects (the "obesity paradox"). We sought to assess the relationship between body mass index (BMI) and the BARI score (BARIsc), a validated tool used to assess myocardium at risk, in patients with acute coronary syndrome.

Patients and methods: Participants were 116 consecutive patients (mean age, 60.6 years; 97 men) with AMI (68 ST elevated myocardial infarction, STEMI; 48 non-ST elevated myocardial infarction, NSTEMI). Demographics, BMI, risk factors, biochemistry data, left ventricular function, angiographic data and the BARIsc were assessed in every patient.

Results: Multiple linear regression analyses showed that BMI significantly correlated with BARIsc; β=.23, p<0.02. This was found only in the overweight/obese patients, β=.27, p<0.01, but not in patients with normal BMIs, β=0.08, p=0.71.

Conclusions: An increased body weight is associated with an increased area of myocardium at risk in patients with ACS.

Keywords: Acute coronary syndrome; Acute myocardial infarction; BARI score; Infarto agudo de miocardio; Obesity paradox; Paradoja de la obesidad; Puntuación BARI; Síndrome coronario agudo.