Obesity and Age of First Non–ST-Segment Elevation Myocardial Infarction

Obesity and Age of First Non–ST-Segment Elevation Myocardial Infarction Mohan C. Madala, Barry A. Franklin, Anita Y. Chen, Aaron D. Berman, Matthew T. Roe, Eric D. Peterson, E. Magnus Ohman, Sidney C. Smith, Jr, W. Brian Gibler, Peter A. McCullough, for the CRUSADE Investigators Because excess adiposity is one of the most important determinants of adipokines and inflammatory factors associated with coronary plaque rupture, we hypothesized that obesity was associated with myocardial infarction at earlier ages. We retrospectively examined the relationship of body mass index (BMI) with patient age of first non–ST-segment elevation myocardial infarction (NSTEMI) in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines) registry. The age of first NSTEMI occurred 3.5, 6.8, 9.4, and 12.0 years earlier with ascending levels of adiposity (BMI 25.1 to 30.0, 30.1 to 35.0, 35.1 to 40.0, and >40.0 kg/m2 , respectively; referent 18.6 to 25.0 kg/m2 ); p < 0.0001 for each estimate. These data suggest that as the obesity pandemic worsens, NSTEMI might occur at increasingly younger ages.