title: Absence of obesity paradox in Saudi patients admitted with acute coronary syndromes: insights from SPACE registry.
abstract: OBJECTIVE
  To 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).
  
  
  METHODS
  The 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.
  
  
  METHODS
  BMI was available for 3469 patients (68.6%) admitted with ACS and categorized into 4 groups: normal weight, overweight, obese, and morbidly obese.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  High 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.
authors.affiliation: Dr. Abdulelah Fahad Mobeirek, Cardiac Sciences, King Saud University,, PO Box 93254 Riyadh 11673,, Saudi Arabia, F: 966.11-4671158, amobeirek@yahoo.com.
authors.forename: Abdulelah Fahad
authors.initials: AF
authors.lastname: Mobeirek
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Habib
authors.forename: Husam
authors.initials: H
authors.lastname: Al-Faleh
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hersi
authors.forename: Tarek
authors.initials: T
authors.lastname: Kashour
authors.forename: Anahar
authors.initials: A
authors.lastname: Ullah
authors.forename: Layth Ahmed
authors.initials: LA
authors.lastname: Mimish
authors.forename: Shukri
authors.initials: S
authors.lastname: AlSaif
authors.forename: Amir
authors.initials: A
authors.lastname: Taraben
authors.forename: Khalid
authors.initials: K
authors.lastname: Alnemer
authors.forename: Mostafa
authors.initials: M
authors.lastname: Alshamiri
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D048909:Diabetes Complications / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D063868:Patient Outcome Assessment; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012529:Saudi Arabia / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects; D016008:Statistical Distributions; D016896:Treatment Outcome