Dr Heinz Buettner, head of interventional cardiology at Herz-Zentrum, Krozingen, Germany and his colleagues followed 1,676 consecutive patients in a prospective study who had been admitted to hospital suffering from unstable angina/non-ST-segment elevation myocardial infarction between 1996 and 1999. Coronary angiography was performed to diagnose the extent of the problem and then the patients were usually treated with early coronary revascularisation, primarily by inserting stents to widen the relevant artery, or by coronary artery bypass grafting.
A third of the patients (551) had a normal body mass index (BMI), half (824) were overweight, and 18 percent (292) were obese or very obese. The obese and very obese patients tended to be younger, more likely to have hypertension and diabetes already, but less likely to have suffered an earlier heart attack. They were also more likely to be discharged from hospital after treatment with prescriptions for statins, ACE-inhibitors and beta-blockers.
“After three years of follow-up, we found that obese and very obese patients had less than half the long-term mortality when compared with normal BMI patients; 9.9 percent of normal BMI patients and 7.7 percent of overweight patients had died at the end of the three years, but only 3.6 percent of obese patients had died and no very obese patients had died”, he said. The reduction in mortality rates was consistent among all sub-groups and persisted after adjustment for a number of variables. These findings contrast with primary prevention studies that implicate BMI as a strong risk factor for mortality.
Dr Buettner said his study was limited to describing the association observed between obesity and improved survival, and it was not possible to say what might be causing it.
MEDICA.de; Source: European Heart Journal