ArticleAmerican heart journal2016
Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined.
Article in American heart journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Effect of the Obesity Paradox on Mortality in Patients with Acute Coronary Syndrome: A Comprehensive Meta-analysis of the LiteratureBalkan medical journal · 2023Pooled it
- Overweight predisposes to microvascular obstruction: insights from the TATORT-NSTEMI trial.The international journal of cardiovascular imaging · 2026Trial
- Survival After the First Myocardial Infarction in Older Women: A Prospective Cohort Analysis From the WHI.Journal of the American Heart Association · 2026Article
- The association between triglyceride glucose-body mass index and all-cause mortality in critically ill patients undergoing cardiac surgery: a retrospective analysis from the MIMIC-IV database.BMC cardiovascular disorders · 2025Article
- Onboarding obesity management in cardiovascular care: A cardiologist's guide to latest advances.American journal of preventive cardiology · 2025Review
- Impact of obesity on clinical outcomes in patients with high-risk pulmonary embolism: A comparative analysis.International journal of cardiology. Heart & vasculature · 2025Article
- Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients.American journal of preventive cardiology · 2025Article
- Trends in mortality from acute myocardial infarction among the obese population in the United States from 1999 to 2020: insights from CDC WONDER.Archives of medical sciences. Atherosclerotic diseases · 2025Article
- Physical activity and cardiovascular risk in obese older Korean women: effects on obesity, hypertension, and arterial stiffness.Frontiers in public health · 2025Article
- Is there an obesity paradox in cardiovascular outcomes for patients undergoing Transcatheter Edge-to-Edge Repair? A pilot meta-analysis.International journal of cardiology. Heart & vasculature · 2024Review
- Outcome of Pulmonary Embolism with and without Ischemic Stroke.Journal of clinical medicine · 2024Article
- Article
- Association between triglyceride glucose-body mass index and all-cause mortality in critically ill patients with acute myocardial infarction: retrospective analysis of the MIMIC-IV database.Frontiers in nutrition · 2024Article
- Association of body mass index with perioperative blood transfusion and short-term clinical outcomes in patients undergoing isolated coronary artery bypass grafting.BMC anesthesiology · 2023Article
- Obesity phenotypes and cardiovascular risk: From pathophysiology to clinical management.Reviews in endocrine & metabolic disorders · 2023Review
- Obesity paradox or hypoxia preconditioning: How obstructive sleep apnea modifies the Obesity-MI relationship.Sleep medicine · 2023Article
- The Impact of Body Mass Index on In-Hospital Mortality in Post-Cardiac-Arrest Patients-Does Sex Matter?Nutrients · 2023Article
- Association of body mass index with 30-day mortality and red blood cell transfusions in open heart surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2023Article
- Use of machine learning models to predict in-hospital mortality in patients with acute coronary syndrome.Clinical cardiology · 2023Article
- Survival benefit of overweight patients undergoing MitraClip® procedure in comparison to normal-weight patients.Clinical cardiology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAn "obesity paradox" has been described in patients with acute myocardial infarction (AMI), whereby obese and overweight patients have a lower risk of short-term mortality after AMI than normal-weight patients. However, the long-term association of obesity with mortality after AMI remains unknown.
methodsWe used data from the Cooperative Cardiovascular Project, a prospective medical record study of Medicare beneficiaries hospitalized with AMI with 17 years of follow-up (N = 124,981), to evaluate the association of higher body mass index (BMI) with short- and long-term survival after AMI. Cox proportional hazards models were used to estimate life expectancy after AMI and the years of potential life lost or gained attributable to excess weight.
resultsApproximately 41.5% of patients were classified as normal weight; 38.7%, as overweight; 14.3%, as obese; and 5.5%, as morbidly obese. Normal-weight patients had the highest crude mortality at all follow-up time points, whereas obese patients had the lowest. Adjustment for patient and treatment characteristics reduced this difference, but the survival benefit persisted in overweight and obese patients at all time points. Morbidly obese and normal-weight patients had a comparable risk of death at 17 years. Life expectancy estimates were generally lowest for morbidly obese patients and highest for overweight patients. Differences in life expectancy between BMI groups were most pronounced in younger patients. After adjustment, overweight and obesity were associated with greater life years at all ages; however, morbid obesity was only associated with better survival in patients ≥75 years of age at the time of AMI.
conclusionsOverweight and obesity are associated with improved short- and long-term survival after AMI, which results in moderate gains in life expectancy relative to normal-weight patients. These findings suggest that higher BMI confers a protective advantage over the entire remaining lifespan in older patients with AMI.
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