Obesity is associated with worse long-term outcomes in hypertrophic cardiomyopathy patients with acute myocardial infarction

Background: Hypertrophic cardiomyopathy is associated with poor prognosis. In our previous study, it has been reported that patients with acute myocardial infarction and hypertrophic cardiomyopathy exhibited worse long-term outcomes than those with acute myocardial infarction without hypertrophic cardiomyopathy and those with hypertrophic cardiomyopathy without acute myocardial infarction. In this article, we aimed to assess the impact of body mass index on the long-term outcomes of hypertrophic cardiomyopathy patients with acute myocardial infarction. Methods: Seventy-eight consecutive patients with hypertrophic cardiomyopathy and acute myocardial infarction were included. Obesity was defined as body mass index > 28 kg/m(2) adapted to Chinese. The long-term endpoints were major adverse cardiac events and secondary endpoints, which included re-hospitalization, recurrent angina, thrombosis, bleeding, heart failure, and arrhythmias. Results: There were no differences in observed in-hospital mortality or 5-year mortality between the two groups of hypertrophic cardiomyopathy and acute myocardial infarction patients divided by body mass index. However, significantly increased incidence of re-percutaneous coronary intervention and stroke was observed in the obese group (re-percutaneous coronary intervention: 0.0% vs. 21.4%, p = 0.007; stroke: 5.6% vs. 28.6%, p = 0.042). The 5-year outcomes of major adverse cardiac events were inferior in the obese group (log-rank p = 0.020). Conclusion: Acute myocardial infarction and hypertrophic cardiomyopathy patients who were obese exhibited worse long-term outcomes than those without obesity.