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Prognostic impact of body mass index on in-hospital bleeding complications after ST-segment elevation myocardial infarction

查看全文 作　　者：Delphine [1]Ingremeau;Sylvain [1,2]Grall;Florine [3]Valliet;Laurent [4]Desprets;Fabrice [1,2]Prunier;Alain [1,2]Furber;Loïc [1,2]Bière 高影响力作者 机构地区：[1]Department of Cardiology,Angers University Hospital,Angers 49933,France;[2]UMR CNRS 6015-INSERM U1083,Institut MitoVasc,University of Angers,Angers 49100,France;[3]Department of Cardiology,Saumur Hospital,Saumur 49403,France;[4]Department of Cardiology,Cholet Hospital,Cholet 49300,France高影响力机构 出　　处：《World Journal of Cardiology》索引2020年第12卷第1期,共11页高影响力期刊 摘　　要：BACKGROUND ST-elevation myocardial infarction(STEMI)remains a major cause of mortality despite early revascularization and optimal medical therapy.Tailoring individual management by considering patients’specificities may help in improving post-STEMI survival.AIM To evaluate whether in-hospital bleeding complications may be involved in post STEMI prognosis among overweight patients.METHODS We prospectively included 2070 patients with a STEMI between January 2005 and December 2012 in the French observational cohort,“Registre d’Infarctus Maine-Anjou”.Bleeding Academic Research Consortium(BARC)in-hospital bleeding complications were recorded.RESULTS Of 705 patients(35.3%)were presented as being of normal weight,defined as a body mass index(BMI)<25 kg/m^2,877(43.9%)had a BMI between 25 and 30 kg/m^2and 416(20.8%)had a BMI≥30 kg/m^2.One-year cardiovascular mortality was lower for BMI≥25 kg/m^2(5.3%and 7.1%)patients than for normal weight patients(10.8%)(P=0.001).We found an interaction between the effect of BARC 3 on mortality and BMI groups.While a BARC 3 was related to a higher 1-year mortality in general(HR:2.58,95%CI:1.44-4.64,P≤0.001),prognosis was even worse in normal weight patients(HR:2.97,95%CI:1.61-5.5,P<0.001)than for patients with a BMI≥25 kg/m^2(HR:1.94,95%CI:1.02-3.69,P=0.041).CONCLUSION Normal weight patients presented higher rates of in-hospital bleeding complications and lower survival after a STEMI.Excess mortality might be due to greater vulnerability to bleeding amongst normal weight patients. 关 键 词：Myocardial infarction Body mass index Bleeding complications Obesity paradox
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