Impact of Body Weight and Extreme Obesity on the Presentation, Treatment, and In-Hospital Outcomes of 50,149 Patients With ST-Segment Elevation Myocardial Infarction

Results The proportions of patients with STEMI by BMI category were as follows: underweight (BMI 18.5 kg/m) 1.6%, normal weight (18.5 kg/m BMI 25 kg/m) 23.5%, overweight (25 kg/m BMI 30 kg/m) 38.7%, class I obese (30 kg/m BMI 35 kg/m) 22.4%, class II obese (35 kg/m BMI 40 kg/m) 8.7%, and class III obese 5.1%. Extreme obesity was associated with younger age at STEMI presentation (median age 55 years for class III obese vs. 66 years for normal weight); a higher prevalence of diabetes, hypertension, and dyslipidemia; a lower prevalence of smoking; and less extensive coronary artery disease and higher left ventricular ejection fraction. Process-of-care measures were similar across BMI categories, including the extremely obese. Using class I obesity as the referent, risk-adjusted in-hospital mortality rates were significantly higher only for class III obese patients (adjusted odds ratio: 1.64; 95% confidence interval: 1.32 to 2.03).