الفهرس 
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Abstract
Summary
Background:
Obesity is a recognized as health problem in numerous countries around the world. Although obesity has been implicated as a traditional risk factor for coronary artery disease, several studies revealed that obese patients with acute coronary syndrome may have a better outcome – the so called obesity paradox. By contrast, these data was not supported by other several studies generating considerable debate in recent literature.
Methods:
We evaluated 149 patients with acute ST elevation myocardial infarction (STEMI) to investigate the impact of body mass index on presentation and outcome of STEMI. Patients were classified by body mass index (BMI) according to WHO criteria into obese group (BMI ≥ 30 Kg/m2) (n=61) and non obese group (BMI ≤ 29.9) (n=88). Presence of abdominal obesity were assessed in 142 patients (waist circumference is > 102 cm in males, and > 88 cm in females) (n=72).
The main points of concern to be studied are prodromal symptoms, complications, outcome, maximum and summation of ST elevation, echocardiographic parameters including wall motion score index, and severity of coronary artery disease as assessed by number of lesions, number of diseased vessels, and Gensini score.
Results:
The obese group had higher prevalence of hypertension, diabetes mellitus, higher percent of patients which already were on acetylsalicylic acid and statins before presentation. The non obese group had a higher percent of males and higher prevalence of smoking.
The obese group as compared with the non obese group had lower percent of patients that had STEMI as first manifestation without prior anginal pains (p=.01).There was a similar trend in patients with abdominal obesity as compared with patients without abdominal obesity but there was not a significant difference between both groups.
The obese group had lower mortality rate than the non obese group by an unadjusted analysis (p=.047). By multivariate analysis, the difference in mortality rate between both groups remained statistically significant (p=.049).
Comparison between patients with abdominal obesity and patients without abdominal obesity by unadjusted analysis did not demonstrate this relationship between obesity and mortality rate. However patients with abdominal obesity had lower maximum ST elevation (p=.02), and summation of ST elevation (p=.01).