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Atherosclerosis Burden in Patients with Acute Chest Pain: Obesity Paradox
Journal article   Open access   Peer reviewed

Atherosclerosis Burden in Patients with Acute Chest Pain: Obesity Paradox

Kongkiat Chaikriangkrai, Mahwash Kassi, Sayf Khaleel bala, Faisal Nabi and Su Min Chang
ISRN obesity, Vol.2014, 634717
01/12/2014
DOI: 10.1155/2014/634717
PMCID: PMC3913455
PMID: 24555162
url
https://doi.org/10.1155/2014/634717View
Published (Version of record) Open Access

Abstract

Obesity paradox has been described in various populations of coronary artery disease, mainly asymptomatic subjects. However, relationship between obesity and coronary artery calcification detected by cardiac CT in symptomatic patients has rarely been demonstrated. This study seeks to investigate whether the paradoxical relationship between obesity and coronary artery calcification exists in patients with acute chest pain. A final cohort of 1030 chest pain patients presenting at our emergency department who underwent coronary evaluation by multidetector cardiac CT were examined. With absent-to-mild coronary calcification (CAC score < 100) as a referent, multivariable analysis showed that presence of obesity (OR 0.564; 95% CI 0.395, 0.806; P 0.002), body mass index (OR 0.945; 95% CI 0.920, 0.971; P < 0.001 ), body weight (OR 0.987; 95% CI 0.979, 0.995; P 0.001), and body surface area (OR 0.582; 95% CI 0.369, 0.920; P 0.020) were inversely associated with moderate-to-severe coronary calcification (CAC score ≥ 100). This study extends the concept of obesity paradox to symptomatic patients undergoing coronary artery calcium score assessment. However, biological explanation(s) of this paradox remains unanswered.

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