Fat-Free Mass and Body Fat in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention

Vojko Kanic,Barbara Frank, Ivana Sokolovic, Nina Glavnik,Meta Penko

American Journal of Cardiology（2022）SCI 3区

Cited 4|Views7

Abstract

There are no data on the effects of fat-free mass (FFM) and body fat (BF) on prognosis in patients with myocardial infarction (MI). We investigated the effects of FFM and BF (which were estimated using formulas rather than direct measurements) on 30-day and long-term all-cause mortality in patients with MI who underwent percutaneous coronary intervention. We analyzed data from 6,453 patients with MI. The patients were divided into 2 categories (high/low) according to the fat-free mass index (FFMI) and 2 categories (low/high) according to the BF. The resultant 4 patient groups: High FFMI-Low BF, High FFMI-High BF, Low FFMI-Low BF, and Low FFMI-High BF, were compared. The lowest crude mortality after 30 days and in the long term was observed in the High FFMI-Low BF group (3.0%,9.8%, respectively), followed by the High FFMI-High BF group (6.6%, 27.0%, respectively), the Low FFMI-Low BF group (10.4%, 36.0%, respectively), and the Low FFMI-High BF group (14.7%, 56.8%, respectively). The difference was significant (p < 0.0001), as was the difference between groups. After adjustment, the FFMI-BF groups independently predicted 30-day mortality (p = 0.003), but the risk was similar in all groups. Compared with the High FFMI-Low BF group, the long-term mortality risk was similar in the High FFMI-High BF group (hazard ratio [HR] 1.11, 95% confidence interval [CI] 0.84 to 1.47, p = 0.47), but the Low FFMI-Low BF and Low FFMI-High BF patients had a higher risk (HR 1.59, 95% CI 1.20 to 2.11, p = 0.001, HR 1.40, 95% CI 1.03 to 1.91, p = 0.033, respectively). Body composition predicted mortality better than body mass index in patients with MI. Mortality appeared to be inversely related to FFM, with patients with low FFM and low BF having a particularly high mortality risk. The body composition groups also confirmed the obesity paradox. (C) 2022 The Author(s). Published by Elsevier Inc.

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