ANTHROPOMETRIC MEASUREMENTS - PREDICTORS OF MAJOR ADVERSE EVENTS IN NON-ST ELEVATION MYOCARDIAL INFARCTION PATIENTS AND THEIR SURVIVAL - A COHORT STUDY

Abstract

Objective: To determine the anthropometric measurement that best associatedwith angiographic severity and best predictor of major adverse cardiovascularand cerebrovascular event in patients who are successfully re-vascularized afternon-ST elevation myocardial infarction.

Methodology: This is a prospective cohort study done in Cardiology unit, LadyReading Hospital, Peshawar from 1 July, 2016 to 31 November, 2017. Cohortwas selected on the basis of complete revascularization with DES after non-STelevation MI in the first 6-months period and were followed over a period of 12months with a 3-months clinical and monthly telephonic follow-up, to observe forany major adverse cardiovascular and cerebrovascular events (MACCE). Raisedlevel of BMI, waist, wrist, neck circumferences and waist-to-hip ratio weredefined as >25 kg/m , >102cm and >88cm, >20cm and >18cm, 40cmand 37cm for male and female, and 0.55 ratio respectively. Chi-square testused to correlate anthropometric values with angiographic severity and incidenceof MACCE. Logistic regression model was applied for prediction of MACCE.Kaplan-Meier curve used for survival of these patients through one year.

Results: Total of 73 patients having successful revascularization after NSTEMI,with a mean age of 59.25 ± 10.34 years were enrolled in the study. Of these47.9% were males, 31 (42.4%) patients had triple vessel disease. Neckcircumference was best correlated with angiographic severity (X =22.59)followed by BMI (X = 22.2) with significant p-value for all except for waistcircumference. Similarly, all were associated with incidence of MACCE, withwrist as the best (X = 16.12) followed by neck circumference. Relative risk foroccurrence of MACCE was with NC (RR=4.5). Kaplan Meier curves showedsignificant correlation of raised anthropometric values with incidence of MACCEi.e. all patients who had MACCE had raised anthropometric values except for twocases who had normal wrist circumference.

Conclusion: Raised anthropometric values are significantly associated withangiographic severity and incidence of MACCE in NSTEMI patients, with the neckcircumference as its best predictor. Follow-up of these patients show similarsignificant results for MACCE occurrence.