Abstract 11098: Height is a Strong Predictor of Long-term Mortality in Patients With Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention.
Introduction: The impact of anthropomorphic indices on prognosis in patients with ST elevation MI (STEMI) is controversial. Since most available data have very short follow-up time and derive from clinical trials with fibrinolysis, they are be subject to selection bias and to overemphasize the role of in-hospital bleeding. No data are available in unselected patients undergoing primary PCI (pPCI).
Hypothesis: Height and weight may be independent predictors of long-term mortality among STEMI patients undergoing pPCI.
Methods: Consecutive patients with STEMI undergoing pPCI in 2005–2007 in our Department (n=632, age 62±12 years, 76% men, height 169±8 cm, weight 75±14 Kg) were enrolled.
Results: Total mortality over a median follow-up of 3 years was 12.7% (80 patients). Women were older than men (68±13 vs. 61±12 years, p<0.0001) and had higher mortality (28/150, 18.7% vs. 52/482, 10.4%, p=0.02). Height was a strong predictor: mortality was 28/333 (8.4%) among patients ≥ 170 cm but 52/299 (17.4%, p=0.001) among patients < 170 cm. Furthermore, mortality was 3.5% among patients ≥ 180 cm, 9.4% among patients 170–179 cm, 14.6% among patients 160–169 cm and 27.0% among patients < 160 cm (p<0.0001 for trend). Within males, patients ≥ 170 cm had an 8.4% mortality, patients < 170 cm a 15.6% mortality (p=0.02). Mortality was 7.7% among patients ≥ 75 kg but 17.5%, among patients < 75 kg (p=0.0003). However, mortality was 9.4% in patients ≥ 85 kg, 6.1% in patients 75–84 kg, 16.6% in patients 65–74 kg and 18.7% in patients < 65 kg, a significant (p=0.001), but not monotone trend. Significant predictors of all-cause mortality by Cox survival multivariable regression model including all variables available at entry were age (HR 1.07, p<0.0001), heart rate at first medical contact (HR 1.02, p=0.0002), height (HR 0.94, p=0.002), but not female gender (HR 1.52, p=0.15), diabetes or body weight.
Conclusions: Height is a simple and strong predictor of long-term all-cause mortality, with patients <170 cm having more than twice the mortality compared to taller patients. This predictive role is independent of gender, age, weight and diabetes. In the pPCI era height may be a better predictor than weight and the possibility to replace it in risk scores such as TIMI should be considered.
- © 2010 by American Heart Association, Inc.