Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients

Aims: To investigate the association between body mass index (BMI) at acute myocardial infarction (AMI) and all-cause as well as cause-specific long-term mortality. Methods: The analysis was based on 10,651 hospitalized AMI patients (age 25–84 years) recorded by the population-based Myocardial Infar...

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Main Authors: Timo Schmitz, Dennis Freuer, Philip Raake, Jakob Linseisen, Christa Meisinger
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:American Journal of Preventive Cardiology
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Online Access:http://www.sciencedirect.com/science/article/pii/S266666772400268X
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author Timo Schmitz
Dennis Freuer
Philip Raake
Jakob Linseisen
Christa Meisinger
author_facet Timo Schmitz
Dennis Freuer
Philip Raake
Jakob Linseisen
Christa Meisinger
author_sort Timo Schmitz
collection DOAJ
description Aims: To investigate the association between body mass index (BMI) at acute myocardial infarction (AMI) and all-cause as well as cause-specific long-term mortality. Methods: The analysis was based on 10,651 hospitalized AMI patients (age 25–84 years) recorded by the population-based Myocardial Infarction Registry Augsburg between 2000 and 2017. The median follow-up time was 6.7 years [IQR: 3.5–10.0)]. Cause-specific mortality was obtained by evaluating the death certificates. In multivariable-adjusted COX regression models using cubic splines for the variable BMI, the association between BMI and cause-specific mortality (all-cause, cardiovascular, ischemic heart diseases, cancer) was investigated. Additionally, a subgroup analysis in three age groups was performed for all-cause mortality. Results: Overall, there was a statistically significant U-shaped association between BMI at AMI and long-term mortality with the lowest hazard ratios (HR) found for BMI values between 25 and 30 kg/m². For cancer mortality, higher BMI values > 30 kg/m² were not associated with higher mortality. In patients aged <60 years, there was a significant association between BMI values >35 kg/m² and increased all-cause mortality; this association was missing in 60 to 84 years old patients. For all groups and for each specific cause of mortality, lower BMI (<25kg/m²) values were significantly associated with higher mortality. Conclusions: Overall, a lower BMI – and also a high BMI in patients younger than 60 years - seem to be a risk factors for increased all-cause mortality after AMI. A BMI in a mid-range between 25 and 30 kg/m² is favorable in terms of long-term survival after AMI.
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spelling doaj-art-c16fc0c3dd584c069d50b20ee8048eeb2024-12-08T06:13:04ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-03-0121100899Association between BMI and cause-specific long-term mortality in acute myocardial infarction patientsTimo Schmitz0Dennis Freuer1Philip Raake2Jakob Linseisen3Christa Meisinger4Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany; Corresponding author.Epidemiology, Medical Faculty, University of Augsburg, Augsburg, GermanyUniversity Hospital Augsburg, Department of Cardiology, Respiratory Medicine and Intensive Care, Augsburg, GermanyEpidemiology, Medical Faculty, University of Augsburg, Augsburg, GermanyEpidemiology, Medical Faculty, University of Augsburg, Augsburg, GermanyAims: To investigate the association between body mass index (BMI) at acute myocardial infarction (AMI) and all-cause as well as cause-specific long-term mortality. Methods: The analysis was based on 10,651 hospitalized AMI patients (age 25–84 years) recorded by the population-based Myocardial Infarction Registry Augsburg between 2000 and 2017. The median follow-up time was 6.7 years [IQR: 3.5–10.0)]. Cause-specific mortality was obtained by evaluating the death certificates. In multivariable-adjusted COX regression models using cubic splines for the variable BMI, the association between BMI and cause-specific mortality (all-cause, cardiovascular, ischemic heart diseases, cancer) was investigated. Additionally, a subgroup analysis in three age groups was performed for all-cause mortality. Results: Overall, there was a statistically significant U-shaped association between BMI at AMI and long-term mortality with the lowest hazard ratios (HR) found for BMI values between 25 and 30 kg/m². For cancer mortality, higher BMI values > 30 kg/m² were not associated with higher mortality. In patients aged <60 years, there was a significant association between BMI values >35 kg/m² and increased all-cause mortality; this association was missing in 60 to 84 years old patients. For all groups and for each specific cause of mortality, lower BMI (<25kg/m²) values were significantly associated with higher mortality. Conclusions: Overall, a lower BMI – and also a high BMI in patients younger than 60 years - seem to be a risk factors for increased all-cause mortality after AMI. A BMI in a mid-range between 25 and 30 kg/m² is favorable in terms of long-term survival after AMI.http://www.sciencedirect.com/science/article/pii/S266666772400268XBMIAcute myocardial infarctionLong-term mortalityCause-specific mortality
spellingShingle Timo Schmitz
Dennis Freuer
Philip Raake
Jakob Linseisen
Christa Meisinger
Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients
American Journal of Preventive Cardiology
BMI
Acute myocardial infarction
Long-term mortality
Cause-specific mortality
title Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients
title_full Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients
title_fullStr Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients
title_full_unstemmed Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients
title_short Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients
title_sort association between bmi and cause specific long term mortality in acute myocardial infarction patients
topic BMI
Acute myocardial infarction
Long-term mortality
Cause-specific mortality
url http://www.sciencedirect.com/science/article/pii/S266666772400268X
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