מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Excess adiposity increases the risk of recurrent coronary events following acute myocardial infarction (AMI) by up to 80%, according to a report in the September 1st issue of The American Journal of Cardiology.
The new findings suggest that "following AMI, obese persons should be particularly targeted for proved preventive therapies," Dr. Thomas D. Rea, of the University of Washington, Seattle, and multicenter colleagues write.
The investigators examined the association between body mass index (BMI) and recurrent coronary events in 2541 patients with a first AMI. Forty-one percent of the patients were overweight on admission and 27.8% were obese.
During a median follow-up of 3.0 years, the patients experienced 418 recurrent events. With the exception of patients who were only mildly overweight, the risk of a recurrent coronary event increased significantly as BMI increased, even after adjusting for the effects of age, gender, congestive heart failure, smoking, physical activity and aspirin use.
Moreover, while diabetes, hypertension and dyslipidemia explained part of the link between BMI and recurrent coronary events, they did not explain it all. Therefore, "obesity may confer excess risk" through other mechanisms, the authors suggest, such as "by producing an inflammatory state, promoting thrombosis, or activating the sympathetic nervous system."
The new findings show that overweight persons, particularly those who are obese, should be targeted for preventive interventions following AMI, Dr. Rea's team concludes. "Whether weight loss should be included in these treatments is an important but unsettled question," they point out.
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