シガ ツヨシ   Tsuyoshi Shiga
  志賀 剛
   所属   医学部 医学科(東京女子医科大学病院)
   職種   客員教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI-II Registry.
掲載誌名 正式名:Journal of the American Heart Association
略  称:J Am Heart Assoc
ISSNコード:2047-9980
掲載区分国外
出版社 Wiley published on behalf of the American Heart Association, Inc.,
巻・号・頁 7(14),online available頁
著者・共著者 Shiga Tsuyoshi†*, Kohro Takahide, Yamasaki Hiro, Aonuma Kazutaka, Suzuki Atsushi, Ogawa Hiroshi, Hagiwara Nobuhisa, Yamazaki Tsutomu, Nagai Ryozo, Kasanuki Hiroshi
発行年月 2018/07
概要 BACKGROUND:Although an "obesity paradox" exists in patients after myocardial infarction, the association between obesity and the risk of sudden cardiac death (SCD) is limited. The aim of this study was to determine whether obesity is associated with an increased risk of SCD in Japanese survivors of acute myocardial infarction.

METHODS AND RESULTS:Pooled data from 2 cohort studies in Japan, JCAD (Japanese Coronary Artery Disease) study and the Heart Institute of Japan Acute Myocardial Infarction-II (HIJAMI-II) registry, comprising of 6216 patients (mean age 65±11 years, 75.2% male) with acute myocardial infarction who were discharged alive, were studied. The patients were categorized into the following body mass index (BMI) groups at baseline according to the World Health Organization classification for Asian populations: BMI <18.5 kg/m2 (n=335), 18.5 to 23 kg/m2 (n=2371), 23 to 27.5 kg/m2 (n=2823), and ≥27.5 kg/m2 (n=687). The main outcomes were all-cause mortality and SCD. During an average follow-up period of 3.6±1.4 years, all-cause mortality was 10.1%, and SCD was 1.2%. Patients with BMI <18.5 kg/m2 had the highest rate of all-cause mortality (adjusted hazard ratio, 1.61; 95% confidence interval, 1.20-2.16), but high BMI (≥27.5 kg/m2) was not associated with mortality compared with patients in the group with BMI ≥18.5 and <23 kg/m2. However, the long-term risk of SCD was increased in the group with BMI ≥27.5 kg/m2 (adjusted hazard ratio, 2.97; 95% confidence interval, 1.24-7.15). Multivariate analysis revealed that BMI ≥27.5 kg/m2 was associated with an increased risk of SCD (hazard ratio, 2.78; 95% confidence interval, 1.35-5.74).

CONCLUSIONS:Obesity (BMI ≥27.5 kg/m2) was associated with the risk of SCD in Japanese patients after myocardial infarction, although an obesity paradox was found for all-cause mortality.
DOI 10.1161/JAHA.118.008633
PMID 29982233