An obesity paradox in patients with myocardial infarction undergoing percutaneous intervention

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

“…The “obesity paradox” phenomenon has been confirmed in HF, myocardial infarction (MI), valve diseases, and arrhythmia. 7 , 8 , 9 , 10 In several studies, unequal presentation of the obesity paradox was shown between sexes, and, specifically, in patients with HF with or without acute coronary syndrome, studies show that the obesity paradox occurred only in men and was not observed in women. 11 , 12 However, in the setting of CS, only a few studies were conducted on the association of obesity with clinical outcomes.…”

Differential associations between body mass index and outcome in different age groups in patients with myocardial infarction

“…In patients with obesity grade III, the protective effect of obesity is most likely annulled by obesity-related conditions. 1 , 3 , 4 , 14 , 16 , 18 , 19 , 20 , 21 This is supported in part by the observation that obesity-related cardiovascular adverse events do not occur at a BMI of less than 35 kg/m2 and that the inflection point of the survival curve is at a BMI between 35 kg/m2 and 40 kg/m2 . 3 , 10 , 16 , 22 , 23 , 24 , 25 The tendency toward higher long-term risk in patients with obesity grade III was also observed in younger age groups but was not significant ( Fig.…”

“…In MI there is an immediate need for additional energy due to the sudden activation of the neurohormonal system and inflammation, and patients with higher levels of obesity and age-related morbidities would require a greater metabolic reserve stored in adipose tissue to survive MI. 3 , 5 , 15 , 16 , 17 This would explain why moderately elevated BMI becomes more important with age ( Fig. 2 ).…”

“… 4 , 14 As patients age, overweight and obese patients probably retain more muscle mass, which in turn allows for better mobility and cardiorespiratory fitness, leading to a better outcome. 3 , 4 , 14 , 27 , 28 This may be another reason moderate obesity is associated with lower mortality risk after the age of 75 years. Unfortunately, our analysis lacked data on physical activity and cardiorespiratory fitness.…”

“…2 However, overweight, and obese patients with established cardiovascular disease paradoxically have a more favorable prognosis, which is called the obesity paradox. 2 , 3 Another problem affecting cardiovascular disease in society worldwide is population aging. Obesity is more prevalent among the elderly: 43%–71% of those over 65 years of age in developed countries are at least overweight, and in middle-income countries, the increase in obesity is greatest among those over 65 years of age.…”