Prognostic Implications of Coronary Microvascular Dysfunction in ST ‐Elevation Myocardial Infarction by Obesity Status
Authors' conclusion
CMD assessed by angio-IMR is an independent predictor of MACCE in STEMI patients with obesity, but not those without obesity.
Study context
- Population
- ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention, stratified by BMI (healthy weight <24 kg/m²; overweight 24–28 kg/m²; obesity ≥28 kg/m²)
- Participants
- 497 patients
- Exposure
- Coronary microvascular dysfunction (CMD) vs non-CMD, stratified by BMI category
- Outcome
- Long-term MACCE
Methodological detailsmulticentre, subgroup analysis by obesity category
- Multicentre
- Subgroup analysis by obesity category
Main finding
As reported in the abstract
Cumulative incidence of MACCE by BMI category
CMD (obesity) vs Non-CMD (obesity): log-rank p = 0.016 · CMD (overweight) vs Non-CMD (overweight): log-rank p = 0.565 · CMD (healthy weight) vs Non-CMD (healthy weight): log-rank p = 0.673 · CMD (obesity) vs Non-CMD (obesity): P = 0.020
- Continuous angio-IMR and MACCE in obesity, aHR
- 1.03 (p < 0.001)
Observational data: associations, not effects.
Further findings
| Outcome | aOR | P value |
|---|---|---|
| Intramyocardial haemorrhage, CMD vs non-CMDCMD (obesity) vs Non-CMD (obesity) | 4.40 | P = 0.003 |
| Intramyocardial haemorrhage, CMD vs non-CMDCMD (overweight) vs Non-CMD (overweight) | 2.65 | P = 0.007 |
CMD prevalence across BMI groups
- CMD prevalence comparable across BMI groups
- P = 0.875
Original publication
Prognostic Implications of Coronary Microvascular Dysfunction in ST ‐Elevation Myocardial Infarction by Obesity Status. Diabetes Obes Metab. Published 24 May 2026. doi:10.
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