Comparative Study of In-Hospital Mortality in ST-Segment Elevation Myocardial Infarction (STEMI) Patients between Obese and Non-obese Groups
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Abstract
BACKGROUND: The impact of obesity on clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to compare demographic characteristics, procedural features, and in-hospital as well as 30-day outcomes between obese and non-obese STEMI patients.
METHODS: This retrospective cohort study included patients with acute ST-segment elevation myocardial infarction (STEMI) who presented within 12 hours of symptom onset and underwent primary percutaneous coronary intervention (PCI) at Rayong Hospital between 2023 and 2024. Patients were categorized into either non-obese or obese groups based on body mass index (BMI). Collected data included demographic characteristics, clinical presentation, coronary lesion characteristics, and procedural details.
RESULTS: A total of 418 patients were included (235 non-obese and 183 obese). The non-obese group was older and had higher mortality both during hospitalization (11.9% vs. 5.5%, p=0.023) and at 30-day follow-up (13.2% vs. 6%, p=0.015). In multivariable logistic regression, cardiogenic shock and respiratory failure requiring intubation were the strongest predictors of mortality, significantly increasing the risk of both in-hospital and 30-day mortality (OR 12.242 and 6.963; OR 9.488 and 5.129, respectively; p<0.001).
CONCLUSIONS: Although obesity was associated with lower in-hospital and 30-day mortality in the univariate analysis, this relationship did not persist after adjustment for covariates in the multivariable logistic regression. The findings suggest a protective trend consistent with the ‘obesity paradox,’ but do not support obesity as an independent predictor of survival.
Thaiclinicaltrials.org number,TCTR20250926001
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