Start Submission Become a Reviewer

Reading: The obesity paradox in hospitalized acute coronary syndrome patients in Israel: A national s...

Download

A- A+
Alt. Display

Research

The obesity paradox in hospitalized acute coronary syndrome patients in Israel: A national survey

Authors:

Michael Shechter ,

Leviev Heart Center, Sheba Medical Center, 52621 Tel Hashomer; The Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, IL
X close

Haim Hammerman,

Department of Cardiology, Rambam Medical Center, Rappaport Medical School, Haifa, IL
X close

Valentina Boyko,

Neufeld Cardiac Research Institute, Sheba Medical Center, 52621 Tel Hashomer, IL
X close

Hanoch Hod,

Leviev Heart Center, Sheba Medical Center, 52621 Tel Hashomer; The Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, IL
X close

Solomon Behar,

Leviev Heart Center, Sheba Medical Center, 52621 Tel Hashomer; The Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv; Neufeld Cardiac Research Institute, Sheba Medical Center, 52621 Tel Hashomer, IL
X close

Shlomi Matetzky

Leviev Heart Center, Sheba Medical Center, 52621 Tel Hashomer; The Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, IL
X close

Abstract

Background: Obesity is a coronary disease risk factor demonstrating inconsistent effects on acute coronary syndrome (ACS) outcome.

Methods: To explore the association of body mass index (BMI) and clinical outcome in ACS patients, we analyzed data of 5751 ACS patients (77% males) from the Acute Coronary Syndrome Israel Survey between March and April during 2002, 2004 and 2006.

Results: Patients were divided into 4 National Institutes of Health, BMI-based categories: underweight (BMI < 18.5 kg/m2, n = 43); normal (BMI = 18.5–24.9 kg/m2, n = 1709); overweight (BMI = 25.0–29.9 kg/m2, n = 2700); obese (BMI ⩾ 30 kg/m2, n = 1299). Mean BMI increased significantly in ACS patients from 2002 to 2006. Time from chest pain onset to hospitalization and invasive procedure, Killip class on admission, left ventricular ejection fraction, creatinine clearance and in-hospital therapy were similar in all four groups. Obese and overweight patients were significantly younger than underweight and normal patients (61.4 ± 12.4 and 63.3 ± 12.6 years vs. 69.9 ± 17.7 and 65.3 ± 13.7 years respectively, p for trend < 0.0001). After multivariable adjustment, overweight patients had the lowest 30-day and 1-year mortality [adjusted odds ratio (OR) 0.52, 95% confidence interval (CI) 0.39–0.68 and hazard ratio (HR) 0.65, 95% CI 0.54–0.78, respectively] followed by obese [OR 0.92, 95% CI 0.66–1.28 and HR 0.91, 95% CI 0.73–1.13], normal [1.0 and 1.0] and underweight patients [1.64, 95% CI 0.59–4.61 and 1.39, 95% CI 0.73–2.63].

Conclusion: Overweight and obese ACS patients were younger with a better survival rate than normal and underweight patients. Our observation of a U-shaped relationship between increasing BMI and mortality in ACS patients warrants cautious prospective evaluation.

How to Cite: Shechter M, Hammerman H, Boyko V, Hod H, Behar S, Matetzky S. The obesity paradox in hospitalized acute coronary syndrome patients in Israel: A national survey. Global Heart. 2010;5(3):81–7. DOI: http://doi.org/10.1016/j.cvdpc.2010.08.002
Published on 01 Sep 2010.

Downloads

  • PDF (EN)

    comments powered by Disqus