Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Nov;29(11):801-12.
doi: 10.1007/s10654-014-9961-9. Epub 2014 Oct 30.

The obesity paradox in acute coronary syndrome: a meta-analysis

Jacek Niedziela  1 , Bartosz Hudzik, Natalia Niedziela, Mariusz Gąsior, Marek Gierlotka, Jarosław Wasilewski, Krzysztof Myrda, Andrzej Lekston, Lech Poloński, Piotr Rozentryt
Affiliations
Meta-Analysis

The obesity paradox in acute coronary syndrome: a meta-analysis

Jacek Niedziela et al. Eur J Epidemiol. 2014 Nov.

Abstract

In the general population, the lowest mortality risk is considered to be for the body mass index (BMI) range of 20-24.9 kg/m(2). In chronic diseases (chronic kidney disease, chronic heart failure or chronic obstructive pulmonary disease) the best survival is observed in overweight or obese patients. Recently above-mentioned phenomenon, called obesity paradox, has been described in patients with coronary artery disease. Our aim was to analyze the relationship between BMI and total mortality in patients after acute coronary syndrome (ACS) in the context of obesity paradox. We searched scientific databases for studies describing relation in body mass index with mortality in patients with ACS. The study selection process was performed according to PRISMA statement. Crude mortality rates, odds ratio or risk ratio for all-cause mortality were extracted from articles and included into meta-analysis. 26 studies and 218,532 patients with ACS were included into meta-analysis. The highest risk of mortality was found in Low BMI patients--RR 1.47 (95 % CI 1.24-1.74). Overweight, obese and severely obese patients had lower mortality compared with those with normal BMI-RR 0.70 (95 % CI 0.64-0.76), RR 0.60, (95 % CI 0.53-0.68) and RR 0.70 (95 % CI 0.58-0.86), respectively. The obesity paradox in patients with ACS has been confirmed. Although it seems to be clear and quite obvious, outcomes should be interpreted with caution. It is remarkable that obese patients had more often diabetes mellitus and/or hypertension, but they were younger and had less bleeding complications, which could have influence on their survival.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram of the study (according to PRISMA statement)
Fig. 2
Fig. 2
Meta-analysis: total mortality risk for Low BMI versus Normal BMI in patients with acute coronary syndrome
Fig. 3
Fig. 3
Meta-analysis: total mortality risk for Overweight versus Normal BMI in patients with acute coronary syndrome
Fig. 4
Fig. 4
Meta-analysis: total mortality risk for Obesity versus Normal BMI in patients with acute coronary syndrome
Fig. 5
Fig. 5
Meta-analysis: total mortality risk for Severe Obesity versus Normal BMI in patients with acute coronary syndrome
Fig. 6
Fig. 6
Risk ratios (RR) assessed in meta-analysis in groups of BMI
See this image and copyright information in PMC

References

    1. OED Online [database on the Internet]. Oxford University Press. 2013 [cited November 20, 2013]. http://www.oed.com.
    1. Colman MDE. Obesity in the paleolithic era? The Venus of Willendorf. Endocr Pract. 1998;4(1):58–59. doi: 10.4158/EP.4.1.58. - DOI - PubMed
    1. Tipton CM. Susruta of India, an unrecognized contributor to the history of exercise physiology. J Appl Physiol. 2008;104(6):1553–1556. doi: 10.1152/japplphysiol.00925.2007. - DOI - PubMed
    1. Gysel C. [Adolphe Quetelet (1796–1874). The statistics and biometry of growth]. Orthod Fr. 1974;45(1):643–77. - PubMed
    1. Obesity: Preventing and managing the global epidemic: World Health Organization; 2000. - PubMed

Publication types

LinkOut - more resources