{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:03:48Z","timestamp":1784693028678,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"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 cardiogenic shock. Method: Using a large Nationwide Inpatient (NIS) sample database, we evaluated mortality in patients with cardiogenic shock based on weight categories in adults. Results: A total of 843,020 patients over age 18 had a diagnosis of cardiogenic shock in the database. We found that overweight and obesity had the lowest mortality using univariate or multivariate analysis (overweight mortality of 20.66% vs. obesity mortality of 26.6% vs. 34.8% of normal weights). In contrast, cachexia was associated with the highest mortality in univariate analysis (cachexia 40.4%). Using multivariate analysis adjusting for age, baseline characteristics, and comorbidities, these relations remained unchanged (cachexia MVOR: 1.13; CI: 1.21\u20131.13; p &lt; 0.001; overweight MVOR: 0.52, CI: 0.43\u20130.65; p &lt; 0.001; obesity MVOR: 0.76, CI: 0.73\u20130.79; p &lt; 0.001). After multivariate adjustment, morbid obesity had similar mortality to patients with normal weight (morbid obesity MVOR: 0.99 CI 0.95\u201301.03; p = 0.6) Conclusions: We observe a partial obesity paradox in patients with cardiogenic shock, showing that being overweight, followed by obesity, has the lowest mortality, whereas cachexia has the highest mortality despite multivariate adjustment.<\/jats:p>","DOI":"10.3390\/jcm14155275","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T14:40:02Z","timestamp":1753454402000},"page":"5275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["In Cardiogenic Shock, Overweight and Obesity Have the Lowest, Whereas Cachexia Has the Highest Mortality"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7492-0510","authenticated-orcid":false,"given":"Mohammad Reza","family":"Movahed","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, Tucson, AZ 85724, USA"},{"name":"Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ 85004, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrdad","family":"Mahalleh","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, Tucson, AZ 85724, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3014-7954","authenticated-orcid":false,"given":"Zahra","family":"Sadin","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, 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, University of Arizona College of Medicine, Phoenix, AZ 85004, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"ref_1","unstructured":"Hales, C.M., Carroll, M.D., Fryar, C.D., and Ogden, C.L. 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