الفهرس 
Acute ST elevation myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
besity is a recognized health problem in numerous countries
around the world. Although obesity has been implicated as
a traditional risk factor for coronary artery disease, several studies
revealed that obese patients with acute coronary syndrome may
have a better outcome – what is called the (obesity paradox). By
contrast, these data were not supported by other fewer studies
generating considerable debate in recent literature.
Methods:
We evaluated 140 patients admitted to the coronary care
unit of Ain shams university and Ain shams university specialized
hospitals with acute ST elevation myocardial infarction (STEMI)
to investigate the impact of body mass index on presentation and
outcome of STEMI.
Patients were classified by body mass index (BMI)
according to WHO criteria into obese group (BMI ≥ 30 Kg/m2)
(n=76) and non obese group (BMI < 30) (n=64). Presence of
abdominal obesity was assessed in all patients (waist
circumference is > 102 cm in males, and > 88 cm in females)
(n=75).
The main points of concern were the demographic data
(Age, sex, weight, height and waist circumference), risk factors,
history of medications, clinical presentation regarding killip class
and site of infarction, reperfusion strategy, echocardiographic parameters including Ejection fraction, wall motion score index
and presence of mitral regurgitation as a mechanical
complication, coronary angiography regarding the culprit vessel
affection and severity of coronary artery disease and the in
hospital complications.
Results:
The obese patients were younger in age than the non obese
patients.
The obese group had higher prevalence of hypertension,
diabetes mellitus and dyslipidemia. The obese patients were more
likely to be on anti platelet and anti ischemic medications before
presentation.
The obese patients were presented earlier than the non
obese patients affecting significantly their prognosis.
The obese patients had better clinical presentation than the
non obese patients as regard killip class. The non obese patients
presented in killip class II were more than the obese patients and
this was statistically significant.
Regarding the echo findings, the occurrence of MR was
significantly higher in the non obese group compared to the obese In our study, we found that the non obese patients were
having in hospital complications 4 times more than the obese
patients and patients with normal waist circumference were
having complications as twice as the patients with high waist
circumference. Patients who had both factors (low BMI and
normal waist circumference) were found to have the worst
prognosis. They had complications 5 times more than patients
who had high BMI and high waist circumference.