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

Mobeirek, Abdulelah F. Al; Alhabib, Khalid F; AlFaleh, Husam; Hersi, Ahmed; Kashour, Tarek; Ullah, Anhar; Mimish, Layth; AlSaif, Shukri; Taraben, Amir; AlNemer, Khalid; Alshamiri, Mostafa Q

doi:10.5144/0256-4947.2014.38

Cited by 10 publications

(6 citation statements)

References 29 publications

(42 reference statements)

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“…This phenomenon is well known as an “obesity paradox”, not only among patients with coronary artery disease (CAD), but also in those with heart failure [ 16 , 17 ]. However, the precise mechanisms of this phenomenon are still unclear [ 18 – 20 ]. Additionally, there are few data regarding the obesity paradox especially in Asian populations, because few studies have been conducted in Asia.…”

Section: Introductionmentioning

confidence: 99%

Impact of Body Mass Index on In-Hospital Complications in Patients Undergoing Percutaneous Coronary Intervention in a Japanese Real-World Multicenter Registry

et al. 2015

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BackgroundObesity is associated with advanced cardiovascular disease. However, some studies have reported the “obesity paradox” after percutaneous coronary intervention (PCI). The relationship between body mass index (BMI) and clinical outcomes after PCI has not been thoroughly investigated, especially in Asian populations.MethodsWe studied 10,142 patients who underwent PCI at 15 Japanese hospitals participating in the JCD-KICS registry from September 2008 to April 2013. Patients were divided into four groups according to BMI: underweight, BMI <18.5 (n=462); normal, BMI ≥18.5 and <25.0 (n=5,945); overweight, BMI ≥25.0 and <30.0 (n=3,100); and obese, BMI ≥30.0 (n=635).ResultsPatients with a high BMI were significantly younger (p<0.001) and had a higher incidence of coronary risk factors such as hypertension (p<0.001), hyperlipidemia (p<0.001), diabetes mellitus (p<0.001), and current smoking (p<0.001), than those with a low BMI. Importantly, patients in the underweight group had the worst in-hospital outcomes, including overall complications (underweight, normal, overweight, and obese groups: 20.4%, 11.5%, 8.4%, and 10.2%, p<0.001), in-hospital mortality (5.8%, 2.1%, 1.2%, and 2.7%, p<0.001), cardiogenic shock (3.5%, 2.0%, 1.5%, and 1.6%, p=0.018), bleeding complications (10.0%, 4.5%, 2.6%, and 2.8%, p<0.001), and receiving blood transfusion (7.6%, 2.7%, 1.6%, and 1.7%, p<0.001). BMI was inversely associated with bleeding complications after adjustment by multivariate logistic regression analysis (odds ratio, 0.95; 95% confidence interval, 0.92–0.98; p=0.002). In subgroup multivariate analysis of patients without cardiogenic shock, BMI was inversely associated with overall complications (OR, 0.98; 95% CI, 0.95–0.99; p=0.033) and bleeding complications (OR, 0.95; 95% CI, 0.91–0.98; p=0.006). Furthermore, there was a trend that BMI was moderately associated with in-hospital mortality (OR, 0.94; 95% CI, 0.88–1.01; p=0.091).ConclusionsLean patients, rather than obese patients are at greater risk for in-hospital complications during and after PCI, particularly for bleeding complications.

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Section: Introductionmentioning

confidence: 99%

Impact of Body Mass Index on In-Hospital Complications in Patients Undergoing Percutaneous Coronary Intervention in a Japanese Real-World Multicenter Registry

et al. 2015

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“…Men also appear like engaging in stressful behaviour (Mohan et al 2008;Badimon et al 2012). Mobeirek et al 2014;Hersi et al 2013;and Harris 2006 argued that all of the various stress have been relevant with higher fatal risks of coronary heart disease.…”

Section: Shortness Of Breathmentioning

confidence: 99%

Nursing Care for a Patient with NSTEMI Admitted to the Coronary Care Unit for Percutaneous Coronary Intervention — A Case Study

Maryati¹,

Dioso

2017

AJSTD

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This case studyaims to demonstrateclinical nursing skills to a patient with myocardial infarction admitted for percutaneous coronary intervention. Nursing care for this patient startedwith a physical assessment and laboratory invesigation analysis. This evaluation was necessary to develop a nursing care plan. The activities in the ward enumerated the medications provided, and the details of the vital signs monitored hourly. The patient was sent to cardiac catheter laboratory at 1030H. From the cardiac catheter laboratory post-percutaneouscoronary intervention to the mid-right coronary artery (1 Drug-Eluting Stent) he was transferred out to Telemetry unit on 11 August2016 at 1500H with Terumo band hemostatic device through radial approach

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“…[7][8][9][10][11][12][13][14][15] The precise mechanism of this phenomenon is unclear. [16][17][18] There are few data regarding the obesity paradox, especially in south Indian populations, because few studies have been conducted. The objective of our study is to evaluate for the presence of obesity paradox among the contemporary South Indian population.…”

Section: Introductionmentioning

confidence: 99%

Obesity Paradox—Does It Exist in the Contemporary South Indian Post-Percutaneous Coronary Intervention Population?

2020

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Background Obesity is a predisposing factor for atherosclerotic coronary arterial disease. Many studies have shown a protective effect of obesity for major adverse cardiovascular events after percutaneous coronary intervention (PCI). Aim The main purpose of this article is to assess the clinical characteristics, invasive angiographic features, and in-hospital cardiovascular events in obese patients compared with normal and underweight patients. We wanted to know the relationship between body mass index (BMI) and outcomes after PCI. Methods We conducted a prospective study among patients undergoing PCI. Between 2017 and 2019, we included 1,669 participants. Multiple logistic regression was performed to determine the effect of BMI on in-hospital adverse events. Results The patients were classified into four groups: obese (BMI ≥30 kg/m2), overweight (BMI 25 to <29.9 kg/m2), normal BMI (BMI 18.51 to <24.9 kg/m2), and underweight (BMI <18.5 kg/m2). Of 1,669 enrolled patients, 1,233 were men, and 436 were women. Among the women, 19 (35.8%) were underweight, 214(25.4%) were normal having normal BMI, 137 (23.5%) were overweight, and 66 (34%) were obese. Among the men, 34 (2.7%) were underweight, 626 (51%) has normal BMI, 445(36%) were overweight, and 128 (10.3%) were obese. Among 840 patients with normal BMI, 797 (95.4%) had no in-hospital events, 39 (4.6%) had in-hospital events. Among 582 patients who were overweight, 30 (5%) had in-hospital events, and 551 (95%) had no in-hospital events. Among 194 patients who were obese, 9 (4.6%) had in-hospital events and 181 (95.4%) had no in-hospital events.There were no in-hospital events in the underweight group. When in-hospital events were compared with different subgroups depending on the weight, it was not statistically significant (for obesity, p = 0.72, and underweight, p = 0.162). When the events in patients with higher than normal BMI (overweight and obese) were compared with events in underweight, it was statistically significant (p = 0.03). It means that a higher BMI was associated with a higher in-hospital event rate. Conclusion A paradox regarding the association of higher BMI with decreased in-hospital events after PCI is not seen in contemporary south Indian post PCI patients.

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

Cited by 10 publications

References 29 publications

Impact of Body Mass Index on In-Hospital Complications in Patients Undergoing Percutaneous Coronary Intervention in a Japanese Real-World Multicenter Registry

Impact of Body Mass Index on In-Hospital Complications in Patients Undergoing Percutaneous Coronary Intervention in a Japanese Real-World Multicenter Registry

Nursing Care for a Patient with NSTEMI Admitted to the Coronary Care Unit for Percutaneous Coronary Intervention — A Case Study

Obesity Paradox—Does It Exist in the Contemporary South Indian Post-Percutaneous Coronary Intervention Population?

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