{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:17:14Z","timestamp":1783531034751,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>The worse nutritional status of patients without obesity after an acute coronary syndrome (ACS) could explain their worse prognosis and the so-called obesity paradox. We performed a retrospective study of all consecutive patients admitted to a hospital for ACS between 2009 and 2020. Nutritional status was analyzed using the CONUT scale, and values &gt; 4 were categorized as moderate-severe malnutrition. We included 2789 patients with a mean BMI of 28.0 (4.6) kg\/m2 and 26.4% with obesity. The mean CONUT index was 2.4 (2.2), and 24.3% had moderate-severe malnutrition. Obese patients had a lower prevalence of moderate-severe malnutrition: 20.0% vs. 25.9% (p = 0.003). The median follow-up was 3 years. A significant interaction between BMI and the CONUT for mortality was verified, and both variables behaved in the opposite way in relation to risk. BMI was associated with lower all-cause (HR: 0.93, 95% CI 0.89\u20130.98) and cardiovascular (HR: 0.93, 95% CI 0.87\u20130.98) mortality risk only in patients with CONUT &gt; 4; however, in patients without malnutrition, BMI obesity was not associated with increased mortality or major cardiovascular events. In conclusion, CONUT-defined nutritional-inflammatory status may partly contribute to the observed obesity paradox in ACS patients.<\/jats:p>","DOI":"10.3390\/jcdd13070314","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:16:18Z","timestamp":1783527378000},"page":"314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nutritional Status and Obesity Paradox in Acute Coronary Syndrome Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0000-7109","authenticated-orcid":false,"given":"Alberto","family":"Cordero","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL), 03010 Alicante, Spain"},{"name":"Departamento de Medicina, Universidad Miguel Hern\u00e1ndez, 03202 Elche, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7371-910X","authenticated-orcid":false,"given":"Vicente","family":"Arrarte","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL), 03010 Alicante, Spain"},{"name":"Departamento de Medicina, Universidad Miguel Hern\u00e1ndez, 03202 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Sand\u00edn","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL), 03010 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d3scar","family":"Moreno-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL), 03010 Alicante, Spain"},{"name":"Endocrinology Department, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7524-0808","authenticated-orcid":false,"given":"Emilio","family":"Flores","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Department, Hospital Universitario de San Juan, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.23736\/S2724-5683.23.06360-3","article-title":"Risk factors for cardiovascular diseases: The focus on primary prevention","volume":"73","author":"Wolska","year":"2025","journal-title":"Minerva Cardiol. 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