{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:25:42Z","timestamp":1791588342385,"version":"4.3.4"},"reference-count":32,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: The obesity paradox has been observed in patients with cardiovascular disease. The goal of this study was to evaluate whether obesity has a protective effect in patients presenting with an ST elevation myocardial infarction (STEMI). Method: Using the large Nationwide Inpatient (NIS) sample database, we evaluated the mortality in patients with a STEMI based on weight categories. Results: A total of 2,161,640 STEMI patients were found in the database over age 18. We found that overweight and obesity had the lowest mortality using univariate (overweight mortality of 5% vs. obesity mortality of 6.5% vs. 10.9% for normal weights) and multivariate analyses (overweight OR: 0.52, CI: 0.43\u2013063; p &lt; 0.001 and obesity OR: 0.7, CI: 0.67\u20130.74; p &lt; 0.001), whereas cachexia was associated with the highest mortality in the univariate (cachexia 24.5%) and multivariate (OR: 2.28, CI: 2.13\u20132.44; p &lt; 0.001) analyses, followed by morbid obesity in the multivariate analysis (OR: 1.07, CI: 1.02\u20131.12; p = 0.004). Conclusions: We observed a partial obesity paradox in patients with a STEMI showing that overweight have the best survival rates followed by obesity. Cachexia followed by morbid obesity had the lowest survival rates.<\/jats:p>","DOI":"10.3390\/jcm13195897","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T11:29:24Z","timestamp":1727868564000},"page":"5897","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["In Patients Presenting with an ST-Elevation Myocardial Infarction, Overweight and Obese Patients Have the Lowest Inpatient Mortality whereas Cachexia Patients Have the Highest Inpatient Mortality Followed by Patients with Morbid Obesity"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7492-0510","authenticated-orcid":false,"given":"Mohammad Reza","family":"Movahed","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Medicine, University of Arizona, Phoenix, AZ 85004, USA"},{"name":"Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Parsa","family":"Abhari","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sarver Heart Center, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4982-8709","authenticated-orcid":false,"given":"Mehrtash","family":"Hashemzadeh","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, University of Arizona, Phoenix, AZ 85004, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4239","DOI":"10.1093\/eurheartj\/ehy294","article-title":"Integrating the results of the CULPRIT-SHOCK trial in the 2017 ESC ST-elevation myocardial infarction guidelines: Viewpoint of the task force","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. 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