Do overweight patients have a better five years prognosis after an acute myocardial infarction treated with coronary intervention?

BACKGROUND Obesity and overweight alone may confer a survival benefit after myocardial infarction, independent of age, medical care or therapy. AIM To evaluate the impact of body mass index (BMI) on long-term mortality in ST-segment elevation acute myocardial infarction (STEMI) patients treated by primary angioplasty (PCI). METHODS We prospectively studied a homogenous group of 131 patients who had suffered STEMI, and subsequently exhibited a TIMI 3 flow after primary PCI. The patients (41 women, 90 men, mean age 58.3 ± 10.8 years) were analysed in two groups: Group 1 - 30 (23%) patients with BMI 〈 25 kg/m(2) and Group 2 - 101 (77%) patients with BMI ≥ 25 kg/m(2). RESULTS Altogether, 19 (14.5%) patients died during the five-year follow-up period - nine out of 30 (30%) were patients with BMI 〈 25 kg/m(2), and ten out of 101 (10%) were patients with BMI ≥ 25 kg/m(2) (p 〈 0.001). Individuals with BMI ≥ 25 kg/m(2) had lower five-year mortality, and this was independent of other potentially confounding variables. Area under the receiver-operating characteristic (ROC) curves for death with respect to weight on ROC analysis was significantly different than for a random model (p 〈 0.05). There were no significant differences in 30-day mortality and one-year mortality (p = 0.6517 and p = 0.3573, respectively). CONCLUSIONS Patients after primary angioplasty for STEMI with BMI 〈 25 kg/m(2) and patients with BMI ≥ 25 kg/m(2) have no difference in 30-day or one-year mortality, but individuals with BMI ≥ 25 kg/m(2) have a better five year prognosis, and this is independent of other potentially confounding variables.