The obesity paradox in patients with acute coronary syndrome: results from the Gulf RACE-2 study.
We investigated the association between in-hospital and peri-hospital mortality and body mass index (BMI)/waist circumference (WC) in a prospective acute coronary syndrome (ACS) registry in the Arabian Gulf. No significant associations with in-hospital mortality were found. Normal BMI had highest peri-hospital mortality, notably those with high WC. In logistic regression of mortality on obesity measures and potential confounders, the effects of obesity measures were no longer significant. In-hospital death increased by 5% with age and decreased by 42% in males. Mortality increased 3.7-fold with ST-elevation myocardial infarction (STEMI) and 3.0-fold with heart failure (HF) but decreased by 33% with dyslipidemia. Peri-hospital death increased by 4% with age and decreased by 30% in males. Mortality increased 2.8-fold with STEMI and 2.4-fold with HF. In- and peri-hospital mortality in ACS is significantly associated with age, gender, STEMI, HF, and dyslipidemia but not obesity measures.
Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates a.shehab@uaeu.ac.ae.
Abdulla
A
Shehab
Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
Bayan
B
Al-Dabbagh
King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Khalid
K
AlHabib
Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine, Boston, MA, USA.
Alawi
A
Alsheikh-Ali
Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Wael
W
Almahmeed
Department of Cardiology, Royal Hospital, Muscat, Oman.
Kadhim
K
Sulaiman
Department of Medicine, Faculty of Medicine, Sana's University, Sana'a, Yemen.
Ahmed
A
Al-Motarreb
Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation (HMC), Doha, Qatar.
Jassim Al
JA
Suwaidi
Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Ahmad
A
Hersi
Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Hussam
H
AlFaleh
Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation (HMC), Doha, Qatar.
Nidal
N
Asaad
Cardiology Department, Saud Al-Babtain Cardiac Center, Dammam, Kingdom of Saudi Arabia.
Shukri
S
AlSaif
Cardiology Department, Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain.
Haitham
H
Amin
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.
Muath
M
Alanbaei
Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
Nicolaas
N
Nagelkerke
Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
Abdishakur
A
Abdulle
D054058:Acute Coronary Syndrome / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012727:Sex Characteristics
ACS; Arabian Gulf; mortality; obesity