Background: The correlation between obesity and metabolic syndrome (MetS) remains unclear.
Purpose: This study aims to investigate impact of obesity phenotype on clinical outcomes with ST-segment elevation myocardial infarction (STEMI).
Subjects and methods: We analyzed in-hospital mortality and major adverse cardiac events (MACE) of 2,606 obese patients who underwent primary percutaneous coronary intervention (PCI) in the Korea Acute Myocardial Infarction Registry from November 2005 to October 2010. Patients were divided into two groups: unhealthy (any of the Mets components) obesity (BMI ≥25 kg/m2) and healthy (none of the Mets components) obesity.
Results: The unhealthy obesity group was composed of 703 patients (27%) and healthy obesity group 1,903 patients (73%). Unhealthy obesity was more frequent in female (25.9% vs. 10.1%, P<0.001) and multi-vessel disease (53.1% vs. 47.6%, P=0.012). There were no significant differences in other baseline characteristics, angiographic and procedural findings, and prescribed medications between two groups. The overall incidence of complications after PCI (13.1% vs. 10.7%, P=0.097) and in-hospital mortality (1.9% vs. 1.6%, P=0.521) were similar in unhealthy obesity group compared with healthy obesity group. By the multivariate Cox regression analyses, the presence of Mets in obese patients was not an independent factor for predicting the adjusted MACE rate at one-month (HR 1.19, 95% CI 0.56–2.54, P=0.645), six-month (HR 1.48, 95% CI 0.94–2.32, P=0.088), and twelve-month (HR 1.10, 95% CI 0.75–1.61, P=0.622).
Conclusion: Obesity phenotype is not an independent prognostic factor for patients with STEMI who undergoing primary PCI. The risk stratification by presence or absence of Mets is not useful in these patients.