Effects of Weight Change on Clinical Outcomes in Overweight and Obese Patients with Acute Myocardial Infarction Who Underwent Successful Percutaneous Coronary Intervention

Obesity is a well-established risk factor for many chronic disorders. However, the effect of weight change after acute myocardial infarction (AMI) is not well known. Among consecutive patients who underwent percutaneous coronary intervention between November 2005 and November 2007 due to AMI, patients who were overweight (23.0≤body mass index [BMI]<27.5 kg/m(2), n=341) and obese (BMI≥27.5 kg/m(2), n=80) were selected for analysis. According to weight change, the patients were divided into 4 groups: Group I (weight loss>5%, n=61), Group II (0%<weight loss≤5%, n=133), Group III (0%≤weight gain<5%, n=181), and Group IV (weight gain≥5%, n=46). We assessed the association between weight change and major adverse cardiac events (MACE). Greater weight loss was more frequent among older individuals (Group I: 64.1±12.4 years, II: 60.6±12.1 years, III: 59.0±11.9 years, IV: 61.4±10.6 years; p=0.028) and patients with diabetes (Group I: 34.4%, II: 27.1%, III: 21.2%, IV: 15.2%; p=0.009). However, there were no significant differences in baseline characteristics or in angiographic or procedural factors except for the proportions of patients with three-vessel disease, which were higher in patients with weight loss (Group I: 20.8%, II: 23.0%, III: 12.5%, IV: 11.6%; p=0.005). The group with greater weight loss had the highest MACE rate at the 12-month clinical follow-up (Group I: 36.9%, II: 25.0%, III: 25.9%, IV: 17.3%; p=0.020). Although weight loss after AMI appears to be associated with worse outcomes, it remains unclear whether the effect is of cardiac origin.