Measures of obesity and outcomes after myocardial infarction.

Overweight and obesity have become increasingly common; worldwide, at least 1.1 billion adults are overweight and 312 million are obese, when overweight and obesity are defined conventionally as having a body mass index (BMI) of 25 kg/m and 30 kg/m, respectively.1,2 In the general population, overweight and obesity are associated with increased risk of developing cardiovascular disease,3,4 and thus it is not surprising that in cohorts of patients with prevalent ischemic heart disease or acute coronary events, well over 50% are overweight or obese.5,6 Despite the association between obesity and cardiovascular risk in the general population, a multitude of studies have described an inverse correlation between BMI and mortality in patients with coronary artery disease (CAD), including post-coronary revascularization patients and those with acute myocardial infarction (MI); the association between elevated BMI and improved survival has been termed the obesity paradox.7,8