{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:07:46Z","timestamp":1792012066219,"version":"4.4.0"},"reference-count":53,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Background: Obesity is an important risk factor for the development of dyslipidemia, diabetes mellitus, hypertension, coronary artery disease, ventricular dysfunction, congestive heart failure (HF), stroke, and cardiac arrhythmias. Objectives: This meta-analysis brings comprehensive evaluation about still controversial association between the body mass index (BMI) and the outcomes of acute coronary syndrome. Method: PubMed\/ScienceDirect databases were systematically searched for studies with baseline parameters, primary (HF, cardiogenic shock, cardiac arrest, reinfarction, stroke, death, total in-hospital complications) and secondary outcomes (reinfarction, stroke, death, total major adverse cardiovascular events [MACE]) in relation to BMI strictly classified into four groups (underweight [&amp;lt;18.5 kg\/m2], normal weight [18.5\u201324.9 kg\/m2], overweight [25.0\u201329.9 kg\/m2], and obese [\u226530.0 kg\/m2], grouped into mildly obese [30.0\u201334.9 kg\/m2] and severely obese [\u226535.0 kg\/m2]). Results: We included 24 studies, with 585,919 participants (55.5% males), aged 66.8 years. Underweight was negatively associated with hypertension, hyperlipidemia and diabetes, and positively with primary outcomes {HF (odds ratio [OR] = 1.37, confidence interval [CI] [1.15\u20131.63]), cardiogenic shock (OR = 1.43, CI [1.04\u20131.98]), stroke (OR = 1.21, CI [1.05\u20131.40]), overall death (OR = 1.64, CI [1.20\u20132.26]), total in-hospital complications (OR = 1.39, CI [1.24\u20131.56])} and secondary outcomes during 34-month follow-up {cardiovascular\/overall death (OR = 3.78, CI [1.69\u20138.49]\/OR = 2.82, CI [2.29\u20133.49]), respectively, total MACE (OR = 2.77, CI [2.30\u20133.34])} (for all p &amp;lt; 0.05). Obesity had positive association with hypertension, hyperlipidemia, diabetes and smoking, and negative with primary outcomes {reinfarction (OR = 0.83, CI [0.76\u20130.91]), stroke (OR = 0.67, CI [0.54\u20130.85]), overall death (OR = 0.55, CI [0.49\u20130.63]), total in-hospital complications (OR = 0.81, CI [0.70\u20130.93])} and secondary outcomes {cardiovascular\/overall death (OR = 0.77, CI [0.66\u20130.88]\/OR = 0.62, CI [0.53\u20130.72]), respectively, total MACE (OR = 0.63, CI [0.60\u20130.77])} (for all p &amp;lt; 0.05). This negative association with several primary outcomes (cardiogenic shock, overall death, total in-hospital complications) and secondary outcomes (cardiovascular\/overall death, total MACE) was more pronounced in mild obesity (p &amp;lt; 0.05). These results give an \u201cobesity paradox\u201d with a bimodal pattern (slightly U-shaped). Conclusions: Obesity is positively associated with traditional cardiovascular risk factors and negatively with primary and secondary outcomes, which confirms the persistence of overall \u201cobesity paradox.\u201d <\/jats:p>","DOI":"10.1159\/000531985","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T21:00:51Z","timestamp":1691528451000},"page":"528-544","source":"Crossref","is-referenced-by-count":17,"title":["Obesity Paradox in the Intrahospital and Follow-Up Phases of the Acute Coronary Syndrome: A Meta-Analysis and Systematic Review"],"prefix":"10.1159","volume":"148","author":[{"given":"Marko","family":"Mornar 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