Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-017
Body Mass Index in Elderly Patients and Myocardial Infarction: The Lesson to Learn From a Lower-Middle Income Country
By Loc Vu, Chinh Nguyen, Mai Hoang, Bao Huy Le, Tran Bao Ngoc Le, Vy Le, Truong Son Dinh, Thi Hoang Yen Ngu, Hong Hieu Truong, Dung Ho, Thach Nguyen
Presenter
Chinh Nguyen
Authors
Loc Vu1, Chinh Nguyen2, Mai Hoang1, Bao Huy Le3, Tran Bao Ngoc Le4, Vy Le5, Truong Son Dinh5, Thi Hoang Yen Ngu6, Hong Hieu Truong7, Dung Ho8, Thach Nguyen5
Affiliation
Tan Tao University, Vietnam1, Can Tho Stroke International Services General Hospital, Vietnam2, Pham Ngoc Thach University of Medicine, Vietnam3, University of Medicine & Pharmacy HCMC, Vietnam4, Methodist Hospital, USA5, Diag Medical Center, Vietnam6, Ascension St. Francis Hospital, USA7, Thong Nhat Hospital, Vietnam8
View Study Report
TCTAP A-017
ACS/AMI
Body Mass Index in Elderly Patients and Myocardial Infarction: The Lesson to Learn From a Lower-Middle Income Country
Loc Vu1, Chinh Nguyen2, Mai Hoang1, Bao Huy Le3, Tran Bao Ngoc Le4, Vy Le5, Truong Son Dinh5, Thi Hoang Yen Ngu6, Hong Hieu Truong7, Dung Ho8, Thach Nguyen5
Tan Tao University, Vietnam1, Can Tho Stroke International Services General Hospital, Vietnam2, Pham Ngoc Thach University of Medicine, Vietnam3, University of Medicine & Pharmacy HCMC, Vietnam4, Methodist Hospital, USA5, Diag Medical Center, Vietnam6, Ascension St. Francis Hospital, USA7, Thong Nhat Hospital, Vietnam8
Background
The Vietnamese people have been haunted by the memories of the famine after the war. However, in the past half-century of freedom, Vietnam's socioeconomic development has led to a significant improvement in quality of life and life expectancy. Especially in the last two decades of the 21st century, the gross domestic product has risen from $31.2 billion (2000) to $410 billion (2022), based on the World Bank report. At the same time, according to the World Health Organization (WHO), life expectancy reached 75 years in 2022. However, the Healthy Life Expectancy (HALE) was 65.4 years, and cardiovascular and metabolic diseases are a growing concern. Particularly, ischemic heart disease moved from 4th to 2nd and diabetes from 9th to 5th in the top ten causes of death in Vietnam. Furthermore, the percentage of adults (18+) with a body mass index (BMI) of 30 kg/m2 or higher has increased significantly from 0.3% (2000) to 2.02% (2021) [data and graph: https://data.who.int/countries/704]. Consequently, diagnosing and managing cardiovascular diseases such as acute coronary syndrome (ACS) has presented new challenges along with aging, comorbidities, and obesity. This study compares MI according to BMI (normal and overweight) in Vietnamese elderly patients.
Methods
A prospective study was performed (June - December 2023). All patients (> 65 years old) diagnosed with MI were continuously retrieved. A comprehensive evaluation was performed on admission according to the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guidelines for the Evaluation and Diagnosis of Chest Pain. The management strategy was based on multi-discipline consultations, patients and their families. The data collection comprised four sections: The initial segment comprised demographic data, encompassing patient hospital identification, age, gender, body mass index (BMI), and smoking status, along with the diagnosis of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). In the second section, which covered comorbidities and medical/clinical history, common disorders such as diabetes, hypertension, hypercholesterolemia, and chronic kidney disease were included in addition to a medical history of MI, PCI, or CABG, as well as a family history of CAD. The third section comprised the type of MI (NSTEMI or STEMI), the therapeutic approach employed, the revascularization strategies (PCI or CABG), and the date of its execution. The last section comprises clinical and laboratory discharge as well as prescriptions. All relevant characteristics were compared between groups with a normal body mass index (BMI) (18.5–24.9) and overweight (≥ 25).
Results
135 patients met the inclusion criteria with a mean age of 74.0 +/- 7.4 years old. which included 52 males. There were 64 NSTEMI patients and 71 STEMI patients. On admission, Killip classification showed four patients were Killip IV, and Killip II and III were 24 and 13 patients, respectively. 117 patients underwent primary PCI. The length of hospital stay was significantly shorter in the overweight group (7.4 ± 5.0 days) compared to the normal BMI group (9.3 ± 4.5 days) (p = 0.023). Additionally, the left ventricular ejection fraction (LVEF) was 54.5 +/- 12.5 in the normal BMI group and 49.4 +/- 13.5 in the overweight group (p = 0.026). Before discharge, the echocardiogram showed the normal BMI group had ten patients with heart failure with a mildly reduced ejection fraction (HFmrEF) and eight with HFrEF, and the overweight group had 14 HFmrEF and 19 HFrEF. There were statistically significant differences (p = 0.03). Besides, the correlation between Killip classification on admission and heart failure at discharge was statistically significant. All patients were stable at discharge.
Conclusion
Preliminary results from the treatment of MI in elderly patients indicated a assocate between overweight and HF. However, overweight patients exhibited shorter hospital stays compared to those with a normal BMI. This suggests that nutrient balance is a critical factor in the recovery of post-MI patients. This finding has significant implications for patient physique and subsequent care.