• Annals of Saudi medicine · Jan 2014

    Absence of obesity paradox in Saudi patients admitted with acute coronary syndromes: insights from SPACE registry.

    • Abdulelah Fahad Mobeirek, Khalid Al-Habib, Husam Al-Faleh, Ahmed Hersi, Tarek Kashour, Anahar Ullah, Layth Ahmed Mimish, Shukri AlSaif, Amir Taraben, Khalid Alnemer, and Mostafa Alshamiri.
    • Dr. Abdulelah Fahad Mobeirek, Cardiac Sciences, King Saud University,, PO Box 93254 Riyadh 11673,, Saudi Arabia, F: 966.11-4671158, amobeirek@yahoo.com.
    • Ann Saudi Med. 2014 Jan 1; 34 (1): 384538-45.

    Background And ObjectivesTo describe the distribution of body mass index (BMI) and its relationship with clinical features, management, and in-hospital outcomes of patients admitted with acute coronary syndromes (ACS).Design And SettingsThe Saudi Project for Assessment of Coronary Events is a prospective registry. ACS patients admitted to 17 hospitals from December 2005-2007 were included in this study.MethodsBMI was available for 3469 patients (68.6%) admitted with ACS and categorized into 4 groups: normal weight, overweight, obese, and morbidly obese.ResultsOf patients admitted with ACS, 72% were either overweight or obese. A high prevalence of diabetes (57%), hypertension (56.6%), dyslipidemia (42%), and smoking (32.4%) was reported. Increasing BMI was significantly associated with diabetes, hypertension, and hyperlipidemia. Overweight and obese patients were significantly younger than the normal-weight group (P=.006). However, normal-weight patients were more likely to be smokers and had 3-vessel coronary artery disease, worse left ventricular dysfunction, and ST elevation myocardial infarction. Glycoprotein IIb-IIIa antagonists were used significantly more in overweight, obese, and morbidly obese ACS patients than in normal-weight patients (P≤.001). Coronary angiography and percutaneous intervention were reported more in overweight and obese patients than in normal-weight patients (P≤.001). In-hospital outcomes were not significantly different among the BMI categories.ConclusionHigh BMI is prevalent among Saudi patients with ACS. BMI was not an independent factor for in-hospital outcomes. In contrast with previous reports, high BMI was not associated with improved outcomes, indicating the absence of obesity paradox observed in other studies.

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