Effect of obesity on long-term prognosis in non-diabetic patients with acute coronary syndrome

Objective　To evaluate the effect of obesity on long-term prognosis in patients with acute coronary syndrome (ACS) but without diabetes. Methods　A total of 571 patients with ACS but without diabetes were included in a retrospective study. The patients were categorized as normal, overweight, and obese groups based on body mass index (BMI) levels. The mean follow-up time was 3 years. The ultimate events were major adverse cardiovascular events (MACE), including primary ultimate events (sudden cardiac death and non-fatal myocardial infarction) and rehospitalization with unstable angina. Results　The incidence of long-term MACE was 33.6%, and it decreased with the increase in BMI levels (P trend=0.031). Obese patients had a lower risk of MACE than their normal weight counterparts (HR=0.58; 95% CI, 0.37-0.91; P=0.016). After multivariable adjustment, the lower risk of MACE in obese patients remained significant (HR=0.60; 95% CI, 0.39-0.94; P=0.027). Conclusions　In a population with ACS but without diabetes, obese patients had a decreased risk of cardiovascular events compared with normal weight patients. In concordance with the data in patients with diabetes or coronary heart disease, the present study has further suggested that obesity may play a protective effect on long-term prognosis in patients with ACS but without diabetes. DOI: 10.11855/j.issn.0577-7402.2014.11.07