Excess body weight, clinical profile, management practices, and hospital prognosis in men and women after acute myocardial infarction

BACKGROUND: Excess body weight is increasingly being recognized as a major health problem in American men and women. It is unclear, however, whether body weight is associated with the demographic and clinical profile, treatment of, and hospital prognosis after acute myocardial infarction (AMI). METHODS: Nonconcurrent prospective epidemiologic investigation of Worcester (Massachusetts) metropolitan residents hospitalized at all 11 greater Worcester medical centers with validated AMI in 1997, 1999, 2001, and 2003. RESULTS: A total of 2008 men and 1505 women were hospitalized with confirmed AMI during the 4 study periods. Approximately 41% of men and 29% of women were classified as being overweight (body mass index [BMI] of 25-29.9), whereas 27% of men and 26% of women hospitalized with AMI were considered to be obese (BMI > or = 30). Obese men and women were significantly younger than individuals of normal weight. Effective cardiac treatment regimens were less often used in men and women of normal body weight, compared with patients who were overweight or obese. After controlling for several potentially confounding prognostic factors, there were no significant differences in the risk of dying during hospitalization for either overweight or obese men and women, compared with patients of normal body weight. Obese men and women were, however, at greater risk for developing heart failure during the acute hospitalization than men and women of normal weight. CONCLUSIONS: The results of this community study suggest an association between BMI and use of different treatment approaches in patients with AMI. Further examination of the impact of excess body weight on hospital outcomes associated with AMI remains warranted.