A Meta-analysis Of The Association Between Obesity And Mortality In Patients With Acute ST-segment Elevation Myocardial Infarction

Objective:High body mass index(BMI)has been shown to be an independent risk factor for coronary heart disease,but many studies have shown a contradictory relationship between the clinical outcomes of patients with high BMI and those with normal and low BMI.The purpose of this study was to systematically evaluate the association between BMI and short-term and long-term mortality in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention(PCI).Methods: Pub Med,The Cochrane Library,EMbase,The Web of science and CNKI databases were used to search the studies.All the selected articles reported a correlation between body mass indexes and outcomes after PCI of the patients with STEMI.Cumulative meta-analysis were also included in these articles.According to the inclusion and exclusion criteria,two searchers independently performed literature screening,data extraction and quality evaluation,and then Meta analysis was performed with STATA12.0 software.Results: A total of 11 cohort studies and 29,013 patients were included in this meta-analysis.The patients with STEMI in-hospital mortality rate in overweight and obese patients was lower than the normal weight patients after PCI.The pooled OR were 0.66(95%CI:0.58-0.76,p=0.118)and 0.60(95%CI:0.51-0.72,p=0.718),for short term(30-days)0.85(95% CI: 0.60–1.21,p=0.207)and 0.58(95%CI: 0.32–1.06,p=0.454),for long-term(no less than one year)mortality were 0.69(95% CI: 0.56–0.85,p= 0.353)and 0.62(95%CI: 0.46–0.83,p=0.921).However,there was no significant difference in all cause mortality between obesity and overweight regardless of time.Conclusion: This meta-analys confirmed the obesity paradox in patients with STEMI after PCI.The obesity paradox exist in the in hospital and long-term conditions.