CLINICAL SPECIFICS OF PATIENTS STATE AFTER REVASCULARIZED MYOCARDIAL INFARCTION, DEPENDING ON THE BASELINE OBESITY STATUS

Aim. Evaluation of comparable clinical specifics of patients after ST elevation myocardial infarction (STEMI) and primary percutaneous intervention, with various grade of obesity.

Material and methods. To the study, consequently 105 males included, post STEMI and primary percutaneous intervention (PCI). In all patients, general obesity (GO) was assessed by body mass index (BMI) and visceral epicardial obesity (EO) by the thickness of epicardial adipose tissue by echocardiography. According to the values, 6 groups of patients were formed with various combination of GO and EO. All patients underwent coronary arteriography in acute stage of MI, levels of adipokines, leptin receptors measured, as the glomerular filtration rate and urine albumin level. Results. It was found that the baseline clinical parameters in patients’ groups significantly correlated with GO and EO and various combination. In EO comparing to non-EO groups there were high prevalence of 2-3-vessel coronary lesion, life threatening rhythm disorders in acute period of myocardial infarction, leptin resistance, albuminuria. In comparison of the groups by presence and absence of GO, there was no clear relation of the same parameters with BMI. Most commonly multifocal atherosclerosis, rhythm disorders, dysadipokinemia and albuminuria were found in the group with GE and EO, that is probably related to higher amount of visceral fat.

Conclusion. Our study confirmed that obesity is a very heterogenic condition, and depending on the criteria chosen for patients groups comparison, it is possible to get different results of cardiovascular risks, of presentation and complications, from the classical view on GE as a negative factor, to a positive “obesity paradox”. Therefore there is no “paradox” of obesity, but the paradox of assessment criteria for the grade and type of obesity.

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