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Body mass index linked to short-term and long-term all-cause mortality in patients with acute myocardial infarction
  1. Rui Yang1,2,3,
  2. Wen Ma1,2,3,
  3. Zi-Chen Wang4,
  4. Tao Huang3,
  5. Feng-Shuo Xu1,2,3,
  6. Chengzhuo Li1,2,3,
  7. Zhijun Dai5,
  8. Jun Lyu1,2,3
  1. 1 Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
  2. 2 School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
  3. 3 Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
  4. 4 Department of Public Health, University of California Irvine, Irvine, CA 92697, California, USA
  5. 5 Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
  1. Correspondence to Dr Jun Lyu, Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, Shaanxi, China; lyujun2020{at}


Purposes of study This study aimed to elucidate the relationship between obesity and short-term and long-term mortality in patients with acute myocardial infarction (AMI) by analysing the body mass index (BMI).

Study design A retrospective cohort study was performed on adult intensive care unit (ICU) patients with AMI in the Medical Information Mart for Intensive Care III database. The WHO BMI classification was used in the study. The Kaplan-Meier curve was used to show the likelihood of survival in patients with AMI. The relationships of the BMI classification with short-term and long-term mortality were assessed using Cox proportional hazard regression models.

Results This study included 1295 ICU patients with AMI, who were divided into four groups according to the WHO BMI classification. Our results suggest that obese patients with AMI tended to be younger (p<0.001), be men (p=0.001) and have higher blood glucose and creatine kinase (p<0.001) compared with normal weight patients. In the adjusted model, compared with normal weight AMI patients, those who were overweight and obese had lower ICU risks of death HR=0.64 (95% CI 0.46 to 0.89) and 0.55 (0.38 to 0.78), respectively, inhospital risks of death (0.77 (0.56 to 1.09) and 0.61 (0.43 to 0.87)) and long-term risks of death (0.78 0.64 to 0.94) and 0.72 (0.59 to 0.89). On the other hand, underweight patients had higher risks of short-term(ICU or inhospital mortality) and long-term mortality compared with normal weight patients (HR=1.39 (95% CI 0.58 to 3.30), 1.46 (0.62 to 3.42) and 1.99 (1.15 to 3.44), respectively).

Conclusions Overweight and obesity were protective factors for the short-term and long-term risks of death in patients with AMI.

  • adult intensive & critical care
  • cardiology
  • clinical physiology
  • health policy
  • intensive & critical care

Data availability statement

Data are available in a public, open access repository.

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Data availability statement

Data are available in a public, open access repository.

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  • RY and WM contributed equally.

  • Contributors Concept: JL, Z-JD, RY and Z-CW. Design: JL, RY and Z-CW. Data collection or processing: RY, WM and Z-CW. Analysis or interpretation: RY, WM, TH and F-SX. Literature search: JL, Z-JD, RY and C-ZL. Writing: RY and all authors controls.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.