• Zdravko Babić, Ivan Zeljković, Hrvoje Pintarić, Mislav Vrsalović, Marko Mornar Jelavić, and Marjeta Mišigoj-Duraković.
• 1Coronary Care Unit, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia; 3School of Medicine, University of Zagreb, Zagreb, Croatia; 4Department of Cardiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5Department of Emergency Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 7Institute for Cardiovascular Prevention and Rehabilitation, Zagreb, Croatia.
• Acta Clin Croat. 2021 Jun 1; 60 (2): 201-208.

AbstractAnthropometric parameters have a role in diagnosing obesity, which increases the risk of acute coronary syndrome (ACS). The aim of the study was to assess the impact of obesity and physical activity level on the severity and long-term prognosis of ACS. A total of 116 patients with ACS were analyzed according to baseline (demography, medical history, anthropometry), severity (clinical presentation, in-hospital complications, laboratory, echocardiography, coronary angiography) and prognostic parameters (major adverse cardiovascular events during a six-year period). The levels of obesity and physical activity (Baecke/Lipid Research Clinics physical activity questionnaires) were compared with a sample of the Croatian general population. Study results showed the subjects with a higher number of narrowed coronary arteries (CAs) to have higher body mass index (BMI) and waist circumference (WC); those with stenosed left anterior descending artery and anterior myocardial infarction (MI) had higher BMI; waist-to-hip ratio (WHR) positively correlated with creatine kinase and negatively with left ventricle ejection fraction (p<0.05). Inactive patients more often had multi-vessel coronary disease and anterior MI; patients with a higher leisure physical activity index had a lower number of affected CAs, lower rate of stent implantations and lower stent length, while those with a higher work physical activity index had a lower rate of anterior MI (p<0.05). During the follow-up, inactive patients had more strokes and deaths (p<0.05). Our patients had higher body weight, WC and WHR, as well as lower leisure time and total physical activity indices than the general population (p<0.05). In conclusion, ACS is less severe and has better long-term prognosis in less obese patients with a higher level of physical activity. Patients with ACS are more obese and have lower total, as well as leisure time physical activity indices than the general population.

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