{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:55:20Z","timestamp":1785322520391,"version":"3.55.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,6,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Several studies have shown that obesity is associated with better outcomes in patients with cardiogenic shock (CS). Although this phenomenon, the \u201cobesity paradox,\u201d reportedly manifests differently based on sex in other disease entities, it has not yet been investigated in patients with CS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 1227 patients with CS from the RESCUE (Retrospective and Prospective Observational Study to Investigate Clinical Outcomes and Efficacy of Left Ventricular Assist Device for Korean Patients With Cardiogenic Shock) registry in Korea were analyzed. The study population was classified into obese and nonobese groups according to Asian Pacific criteria (BMI \u226525.0\u00a0kg\/m\n              <jats:sup>2<\/jats:sup>\n              for obese). The clinical impact of obesity on in\u2010hospital mortality according to sex was analyzed using logistic regression analysis and restricted cubic spline curves. The in\u2010hospital mortality rate was significantly lower in obese men than nonobese men (34.2% versus 24.1%, respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.004), while the difference was not significant in women (37.3% versus 35.8%, respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.884). As a continuous variable, higher BMI showed a protective effect in men; conversely, BMI was not associated with clinical outcomes in women. Compared with patients with normal weight, obesity was associated with a decreased risk of in\u2010hospital death in men (multivariable\u2010adjusted odds ratio [OR], 0.63; CI, 0.43\u20130.92 [\n              <jats:italic>P<\/jats:italic>\n              =0.016]), but not in women (multivariable\u2010adjusted OR, 0.94; 95% CI, 0.55\u20131.61 [\n              <jats:italic>P<\/jats:italic>\n              =0.828]). The interaction\n              <jats:italic>P<\/jats:italic>\n              value for the association between BMI and sex was 0.023.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The obesity paradox exists and apparently occurs in men among patients with CS. The differential effect of BMI on in\u2010hospital mortality was observed according to sex.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02985008.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024143","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T10:05:10Z","timestamp":1654509910000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Impact of the Obesity Paradox Between Sexes on In\u2010Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3963-3142","authenticated-orcid":false,"given":"Woochan","family":"Kwon","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Heart Vascular Stroke InstituteSamsung Medical CenterSungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2337-7826","authenticated-orcid":false,"given":"Seung Hun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Chonnam National University Hospital Gwangju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-1367","authenticated-orcid":false,"given":"Jeong Hoon","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Heart Vascular Stroke InstituteSamsung Medical CenterSungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7511-9581","authenticated-orcid":false,"given":"Ki Hong","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Heart Vascular Stroke InstituteSamsung Medical CenterSungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-3583","authenticated-orcid":false,"given":"Taek Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Heart Vascular Stroke InstituteSamsung Medical CenterSungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-4014","authenticated-orcid":false,"given":"Joo Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Heart Vascular Stroke InstituteSamsung Medical CenterSungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3986-9152","authenticated-orcid":false,"given":"Young Bin","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Heart Vascular Stroke InstituteSamsung Medical CenterSungkyunkwan University School of Medicine Seoul Republic of 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