The Role of Anthropometry in Acute St-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Abstract

SUMMARY -Th e aim of this study was to investigate the controversial infl uence of anthropometry on clinical severity and prognosis of acute ST-elevation myocardial infarction (STEMI). We prospectively analyzed 250 patients with acute STEMI treated with primary percutaneous coronary intervention (September 2011 -September 2012. Th ey were grouped according to the following anthropometric parameters: body mass index (BMI) (<25.0, 25.0-29.9, ≥30.0 kg/m²), waist circumference (WC) (<102/88, ≥102/88 cm), waist-to-hip ratio (WHR) (<0.90/0.85, ≥0.90/0.85) and waistto-height ratio (WHtR) (<53/49, 53/49-62/57, ≥63/58). Th e groups were analyzed by baseline, as well as severity (clinical, laboratory, echocardiography, coronary angiography, in-hospital complications) and prognostic parameters (major adverse cardiovascular events and sick leave duration during 12-month follow up). Patients with BMI <25.0 kg/m 2 had the highest rates of dyspnea and those with BMI ≥30.0 kg/m² had the longest hospitalization and widest stents; patients with WHR ≥0.90/0.85 had higher rates of signifi cantly stenosed proximal/middle coronary segments, while those with WHtR ≥63/58 had the highest rates of heart failure and total in-hospital complications (p<0.05). BMI <25.0 kg/m 2 increased (odds ratio (OR) 2.00, confi dence interval (CI) [1.09-3.68], p=0.026) and BMI 25.0-29.9 kg/m 2 reduced (OR 0.52, CI [0.30-0.91], p=0.022) the risk of dyspnea; WHR ≥0.90/0.85 increased the risk of signifi cant proximal/middle coronary segment stenosis (OR 3.34,.86], p=0.029) and WHtR ≥63/58 the risk of heart failure (OR 2.05, CI [1.13-3.71], p=0.017) and total in-hospital complications (OR 1.94,], p=0.017) (p<0.05). In conclusion, WHR and WHtR are better anthropometric parameters than BMI in predicting acute STEMI severity, while WC has no infl uence on it. Anthropometry has no infl uence on prognosis.

Relation between parameters of body composition and echocardiography in patients with nonvalvular atrial fibrillation

“…Using multivariable logistic regression models, Son et al [24] also found significant relationships between WC and enlargement of LA and LV and LV hypertrophy in healthy male Koreans. Mornar Jelavić et al [16] reported that among patients with acute ST-elevation myocardial infarction (STEMI) treated with the percutaneous coronary intervention (PCI), those with abdominal adiposity defined by greater WHR values had higher rates of significantly stenosed proximal/middle coronary segments, while those with a greater WHtR had the highest rates of heart failure and total in-hospital complications. Markus et al [7] used multivariable-adjusted linear regression models to analyze the effect of changes in body composition measured using BIA during a 5 year period on changes in LV geometry and function.…”

The role of traditional obesity parameters in predicting the number of stenosed coronary arteries (≥ 60%) among patients undergoing cardiac catheterization

“…However, there was no agreement in the literature 12 – 14 with regards to the best obesity parameter for predicting CAD (either stenosis or percentage) or its related symptoms. It has been evidenced in the literature that central obesity is a leading cause of the development of CAD or its related symptoms 20 – 22 .…”

“…They also explained that physicians may suspect CAD among obese patients earlier than among non-obese patients and may therefore pay closer attention to obese patients with regards to the development of CAD or its related symptoms. www.nature.com/scientificreports/ However, there was no agreement in the literature [12][13][14] with regards to the best obesity parameter for predicting CAD (either stenosis or percentage) or its related symptoms. It has been evidenced in the literature that central obesity is a leading cause of the development of CAD or its related symptoms [20][21][22] .…”

“…On the other hand, Mornar Jelavić et al 12 found that WHR, followed by WHtR, was more superior than BMI in significantly predicting the stenosis of coronary arteries (≥ 60%). Similarly, Jelavic et al 13 found that WHR (≥ 0.90 m) had a significantly correlation with the severity of stenosed coronary arteries (stenosis percentage ≥ 70%).…”

Association of Circadian Rhythm with Myocardial Infarction

“…Our finding of a difference in intermediate chronotype and diabetes mellitus type 2 in female patients is important because of the influence of metabolic syndromes on circadian rhythm and CVD. Diabetes type 2 increases the risk of CVD ( 13 , 30 ). Metabolic syndromes, diabetes mellitus type 2, dyslipidemia, and smoking were not associated with ESS score in our study and the study by Whitney et al ( 31 ), whereas other studies found an association ( 15 , 32 ).…”