Age-dependent obesity paradox in acute myocardial infarction prognosis: a cohort study of body mass index and recurrent myocardial infarction
Authors' conclusion
This study presents the first evidence of an age-dependent obesity paradox in AMI. In patients aged ≤60 years, higher BMI reduced recurrent myocardial infarction risk, whereas in those aged >60 years, the protective effect disappeared and reversed, indicating potential harm. These findings highlight the need for age-stratified secondary prevention strategies for AMI. Summary of Principal Study Outcomes.
Study context
- Population
- Acute myocardial infarction (AMI) patients at a tertiary medical center, 2015–2023
- Participants
- 4,023 patients
- Exposure
- Higher vs lower body mass index (BMI), stratified by age ≤60 vs >60 years
- ≤60 yearsn = 1,277
- >60 yearsn = 2,746
- Outcome
- Recurrent MI by BMI, per age stratum
Methodological detailssingle tertiary medical center, multivariable-adjusted Cox proportional hazards models, curve fitting, age-stratified
- Single tertiary medical center
- Multivariable-adjusted Cox proportional hazards models
- Curve fitting
- Age-stratified
Main finding
As reported in the abstract
Estimate (95% CI)P value
≤60 yearshigher BMI associated with lower risk
adjusted HR (BMI) 0.965(0.936–0.994)
P = 0.018>60 yearstrend toward higher risk
unadjusted HR (BMI) 1.032(1.012–1.053)
P = 0.001>60 yearslost statistical significance after adjustment
adjusted HR (BMI) 1.015(0.994–1.037)
P = 0.151Per age stratum, as printed
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Age-dependent obesity paradox in acute myocardial infarction prognosis: a cohort study of body mass index and recurrent myocardial infarction. Int J Obes (Lond). Published 28 February 2026. doi:10.
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