The obesity paradox in patients with acute coronary syndrome: results from the Gulf RACE-2 study

Angiology. 2014 Aug;65(7):585-9. doi: 10.1177/0003319713497087. Epub 2013 Aug 5.


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.

Keywords: ACS; Arabian Gulf; mortality; obesity.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / mortality*
  • Acute Coronary Syndrome / therapy*
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / mortality*
  • Obesity / therapy*
  • Prospective Studies
  • Registries
  • Risk Factors
  • Sex Characteristics