Prognostic impact of body mass index in acute myocardial infarction complicated by cardiogenic Shock: an ECLS-SHOCK subanalysis.
Tobias Schupp, Holger Thiele, Tienush Rassaf et al.
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In 30 seconds
This subanalysis of the multicentre, randomised ECLS-SHOCK trial examined the association between BMI and outcomes in 407 patients with acute myocardial infarction complicated by cardiogenic shock. The primary outcome was 30-day all-cause mortality. Mortality was 53.9% with BMI ≥ 30.0 kg/m², 45.3% with BMI 25.0-29.9 kg/m², and 47.7% with BMI 18.5-24.9 kg/m². Neither higher BMI category was associated with increased mortality versus the normal-BMI reference group, and outcomes did not identify BMI groups with differing benefit or harm from ECLS.
Key findings
- Thirty-day mortality was 53.9%, 45.3% and 47.7% for BMI ≥ 30.0, 25.0-29.9 and 18.5-24.9 kg/m², respectively.
- Compared with BMI 18.5-24.9 kg/m², BMI ≥ 30.0 kg/m² was not associated with mortality (OR = 1.28; 95% CI 0.76-2.16; p = 0.35).
- BMI 25.0-29.9 kg/m² was not associated with mortality versus the reference group (OR = 0.91; 95% CI 0.56-1.46; p = 0.68).
- Safety endpoints did not differ across BMI groups, and no BMI subgroup showed greater benefit or less harm from ECLS.
Why it matters
Patients with obesity in this cohort had substantial 30-day mortality, but BMI categories were not associated with a statistically significant difference in mortality, and did not identify differential ECLS outcomes. These findings suggest BMI alone may not distinguish prognosis or ECLS response in AMI-related cardiogenic shock, while underscoring the high mortality across the studied groups.
What to keep in mind
This was a subanalysis of a trial cohort, and the abstract does not report whether the analysis was powered to detect differences between BMI groups.