Trends and Differences in Management and Outcomes of Cardiac Arrest in Underweight and Obese Acute Myocardial Infarction Hospitalizations
Presenter
Dr. Lina Ya'Qoub, M.D., FSCAI, UCSF Medical Center, Reno, NV
Dr. Lina Ya'Qoub, M.D., FSCAI1, Sri Harsha Patlolla, MBBS2, Pranathi R Sundaragiri3, Wisit Cheungpasitporn2, Rajkumar Doshi, M.D., M.P.H.4, Tanveer Rab, M.D., FSCAI5 and Saraschandra Vallabhajosyula, MD MSc, FSCAI6, (1)UCSF Medical Center, Reno, NV, (2)Mayo clinic, Rochester, MN, (3)JenCare Senior Care Center, Morrow, GA, (4)Northwell Health North Shore University Hospital, Manhasset, NY, (5)Emory University, Brookhaven, GA, (6)Warren Alpert Medical School of Brown University, Providence, RI
Keywords: Acute Coronary Syndromes (ACS) and Coronary
ABSTRACT Background:
There is limited contemporary information on impact of weight status on management and outcomes of cardiac arrest with acute myocardial infarction (AMI-CA).
Methods:
Using the National Inpatient Sample database (2008-2017), we studies outcomes of AMI-CA admissions based on body mass index (BMI) classification: underweight, (<19.9 kg/m2), normal (19.9-24.9 kg/m2) and overweight/obese (>24.9 kg/m2).
Results:
Among a total of 314,609 AMI-CA admissions, 268,764 (85.4%) had normal BMI, 1,791 (0.6%) were identified as underweight, and 44,053 (14.0%) as overweight or obese. Compared to 2008, adjusted temporal trends in 2017 revealed significant increase in prevalence of AMI-CA in underweight and overweight/obese admissions. Underweight admissions were on average older, female, and had higher comorbidity burden. Higher rates of non-ST-segment-elevation AMI, in-hospital arrest, and non-shockable rhythm were seen in underweight admissions
. Coronary angiography, PCI, and mechanical circulatory support were more often used in overweight/obese admissions whereas underweight admissions had the lowest use. Compared to normal BMI, underweight AMI-CA admissions had comparable adjusted in-hospital mortality whereas overweight/obese AMI-CA admissions had lower in-hospital mortality (Figure1).
Conclusions:
Underweight AMI-CA admissions had lower rates of cardiac procedures and comparable in-hospital mortality to those with normal BMI. Overweight/obese AMI-CA admissions had higher rates of cardiac procedures and lower in-hospital mortality.
