Abstract 19806: Age-Dependent Prognostic Value of Low Body Mass Index for Cardiovascular Events in Patients With ST-Segment Elevation Myocardial Infarction
Introduction: Underweight individuals have increased risk of death. The age-dependent relationship between body mass index (BMI) and subsequent cardiovascular events in patients with ST-segment Elevation Myocardial Infarction (STEMI) is not clear.
Hypothesis: We tested the hypothesis that the impact of BMI on subsequent cardiovascular events following STEMI is age-dependent.
Methods: Four-hundred and eighty-one subjects with STEMI were enrolled. Subjects were divided by age 65 years and BMI (20, 24, and 28). Frailty was assessed with gait speed in 200-meter walking test. Subjects were followed for cardiovascular deaths, non-fatal myocardial infarctions, non-fatal ischemic strokes, and congestive heart failure for a median of 5.5 years.
Results: During the follow-up period, 103 subjects experienced cardiovascular events. In all subjects, the lowest BMI group (≤ 20) had the highest risk for cardiovascular events compared to other BMI groups (Hazard ratio [HR] in comparison to BMI 20 to 24 group was 2.19 [95% confidence interval 1.23 to 3.77], versus BMI 24 to 28 group HR 2.64 [1.46 to 4.64], versus BMI ≥ 28 group HR 2.15 [1.05 to 4.59], all p values < 0.05). The prognostic impact of low BMI was significantly higher in subjects aged ≥ 65 years than in those aged ≤ 64 years (P for interaction = 0.021) (Figure). Among subjects aged ≥ 65 years, the subjects in the lowest BMI group were significantly more frail as assessed by gait speed compared to other BMI groups (0.687 [interquartile range 0.545 to 0.924] versus 0.889 [0.733 to 1.010] m/s, p=0.005).
Conclusion: The risk associated with low BMI for subsequent cardiovascular events was age-dependent and higher in older subjects with STEMI, and low BMI was associated with significant frailty in older subjects. <!--EndFragment-->
Author Disclosures: Y. Matsuzawa: None. C. Kawashima: None. R. Sato: None. N. Maejima: None. K. Hashiba: None. N. Iwahashi: None. K. Hibi: Research Grant; Modest; AstraZeneca Co., Ltd, MSD Co., Ltd, Solve Co., Ltd, Biosensors Japan Co., Ltd, Teijin Pharma Co., Ltd, Terumo Co., Ltd, Mochida Pharmaceutical Co., Ltd. Research Grant; Significant; Goodman Co., Ltd, Medtronic Japan Co., Ltd, St. Jude Medical Japan Co., Ltd. Honoraria; Modest; Daiichi-Sankyo Co., Ltd, Boston Scientific Japan Co., Ltd. Consultant/Advisory Board; Modest; Terumo Co., Ltd, St. Jude Medical Japan Co., Ltd. T. Ebbing: None. M. Kosuge: None. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Astrazeneca, Sanofi, Eli Lilly Japan, Research Institute for Production Development, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tanabe, Nihon-Boehringer-Ingelheim, Takeda, Otsuka, Ono. Honoraria; Modest; Astrazeneca, Toa Eiyo Ltd. Honoraria; Significant; MSD, Bayer, Daiichi-Sankyo.
- © 2016 by American Heart Association, Inc.