Impacto clínico da obesidade e dos estágios cardiovascular-renal-metabólico (CKM) em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST)

Abstract

Introduction: Obesity is a global concern that contributes to various health conditions, such as metabolic syndrome, cardiovascular, and renal diseases. It causes hemodynamic and metabolic changes, leading to hypertension, dyslipidemia, and chronic kidney disease. The Cardiovascular-Renal-Metabolic Syndrome (CKM) reflects the interrelation between these conditions, increasing morbidity and mortality. Objectives: To analyze data from the Brasília Cardiovascular Care and Outcomes Registry (B-Care:QCO) of patients admitted for acute coronary syndrome. Specifically, this study focuses on cases of ST-Segment Elevation Myocardial Infarction (IAMCSST), investigating the association between stages of cardiovascular-kidney-metabolic syndrome (CKM) and obesity in the manifestation of clinical symptoms, as well as assessing the prevalence of pre-existing conditions through specifically selected parameters. Method: Using a retrospective approach, the study collects information from 4,004 patients who underwent coronary angiography within 48 hours of hospital admission. Therapeutic decisions were made without knowledge of the study, and the research adhered to ethical guidelines, with approval from the Research Ethics Committee. Data were collected from digital medical records and categorized into obesity and CKM stage variables. Results: The study showed that obesity, especially in advanced CKM stages, increases heart failure, MACE,and mortality in STEMI patients. Advanced CKM patients presented elevated risk scores, reduced ejection fraction, and greater cardiac impairment. CKM progression was a critical prognostic factor, regardless of nutritional status. Standard strategies were limited, highlighting the need for early and individualized interventions. Metabolic control, targeted pharmacotherapy, and a multidisciplinary approach are essential to improving outcomes and reducing complications. Conclusions: Obesity and advanced stages of the cardiovascular-renal-metabolic syndrome (CKM) negatively affect clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI), increasing heart failure, adverse events, and mortality. CKM progression is an independent prognostic factor, exacerbating cardiac and metabolic dysfunctions. These findings underscore theimportance of early multidisciplinary management and individualized strategies for metabolic control and complication reduction. The integration of targeted pharmacological interventions is essential to improve survival. Preventive approaches can help mitigate the cumulative impact of these conditions.