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High Prevalence of Obesity in Young Patients with ST Elevation Myocardial Infarction

Abhijeet Basoor, John F Cotant, Gagan Randhawa, Muhammad Janjua, Aaref Badshah, Michele DeGregorio, Abdul R Halabi, Benjamin Diaczok, Kiritkumar C Patel and Paul Stein
American Heart Hospital Journal Volume 9 No.1

Background: There is growing concern about increasing rates of obesity in young people, and increasing ST elevation myocardial infarction (STEMI) at a younger age. There are only a few studies performed to study the risk factors in STEMI among young populations. Methods: Retrospective chart reviews on all first event STEMI patients between December 2005 and July 2007 were performed. A young population was defined as: men <45 years of age and women <55 years of age. Results: Among 206 patients with STEMI, 36 were young. In young patients with STEMI, 78 % were obese compared with 35 % obese, non-young (p<0.001). Also, among young patients with STEMI, family history of coronary heart disease (CHD) was positive in 39 %, compared with 19 % in non-young patients (p=0.009). This significance for obesity and family history persisted after adjusting for other risk factors using logistic regression (OR 2.96 to 17.75, 95 % CI, p<0.0001 and OR 1.36 to 7.47, 95 % CI, p=0.008, respectively). Conclusion: Obesity and family history of CHD were major risk factors with a higher prevalence in young patients with STEMI than non-young patients.

There is an increasing prevalence of obesity in the young population as well as in older people.1,2 One report showed an increasing incidence of coronary heart disease (CHD) in the young population.3 Obesity is now considered a major and independent risk factor for CHD.4 The role of obesity as a cause of CHD in young patients is a growing concern. Only a few studies have reported an increased prevalence of obesity in young patients with CHD3 or STEMI.5,6,7 Our study examines various risk factors for STEMI in young patients, and demonstrates an association between obesity in young patients and STEMI.

Hypothesis
We hypothesized that in STEMI, young patients might have a higher prevalence of obesity compared to non-young patients.

Methods
A retrospective chart review on all patients with a first episode of STEMI between December 2005 and July 2007 was performed at our community/teaching hospital. Investigations were in accordance with the Declaration of Helsinki. Institutional Review Board approval was obtained. International Classification of Diseases 9 Clinical Modification (ICD 9 CM) codes 410.0-410.6, 410.8, and 410 were used to identify patients with STEMI. We included only patients with a first episode of STEMI.

Demographic information, secondary diagnoses, length of hospital stay, and disposition were retrieved from electronic billing records. Electronic medical records were used for findings at cardiac catheterization, risk factors (including family history for CHD), body mass index (BMI), and outcome.

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  1. Division of Cardiology, 2. Department of Medicine, St Joseph Mercy Oakland, Pontiac
  2. Correspondence: Abhijeet Basoor, MD, Division of Cardiology, Medical Education, Fourth Floor, St. Joseph Mercy Oakland, 44405 Woodward Avenue, Pontiac, Michigan 48341. E: drasbasoor@hotmail.com