Impact of Height on Outcomes in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction: Results From the INTERSTELLAR Registry

초록

Background: There have been epidemiologic reports of impact of height on occurrence and outcomes of various cardiovascular diseases for unclear reason. In this study, we sought to 1) confirm the influence of stature in prognosis of patients who underwent primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) and 2) provide pathophysiologic explanation. Methods: All 1,490 STEMI patients who underwent primary PCI were enrolled and echocardiography were performed after the index procedure. Major adverse cardiac and cerebrovascular events (MACCE)were defined as all-cause mortality, non-fatal myocardial infarction, stroke and unplanned hospitalization for heart failure. We divided our patients into: 1) MACCE (+) vs. MACCE (-) and 2) 1st to 3rdtertile groups according to height. Results: 1) MACCE (+) group was significantly shorter than MACCE (-) group (164±8 vs. 166±8 cm, p=0.012).Meanwhile, body mass index (BMI) was smaller in MACCE (+) group (24±4 vs. 25±3 kg/m2) 2). Impact of short stature as a bad prognosticator was prominent in old (≥70 years) male patients even after adjusting for comorbidities (hazard ratio: 0.951, 95% confidence interval: 0.912-0.991, p=0.017). 3) 1sttertile group experienced MACCE earlier and more frequently (Log Rank p=0.035). 4) On echocardiography, left atrial volume and early diastolic mitral velocity to early diastolic mitral annulus velocity showed inverse relationship with height (p<0.001 for all) despite similar left ventricular ejection fraction (p=0.553). Conclusions: Height affects outcomes after primary PCI for STEMI and its influence is more prominent in old male patients. Short stature serves as a non-modifiable risk factor and might be more important than BMI in Asian patients who are relatively thinner than western population. Key words: Height; Prognosis;MACCE, STEMI; Primary PCI; Echocardiography.