Survey of “Obesity Paradox” in Patients With Chronic Cardiac Symptoms Candidate for Elective Coronary Angiography

Obesity is a major risk factor for cardiovascular diseases (CVDs) and increases morbidity. However, recent studies have shown that obesity improves the prognosis of patients with CVDs, which is named as “obesity paradox”. The current study aimed to investigate the risk factors of coronary artery disease (CAD) and its severity based on angiographic findings according to the syntax score system and their association with obesity severity based on patients’ body mass index (BMI) and to respond to this discrepancy.

This cross-sectional-analytical study analyzed the documents of 260 patients who were diagnosed with stable angina and hospitalized at the Shahid Madani CVDs Center in Tabriz from January 2016 to December 2017 and underwent elective coronary angiography.

The mean age of patients was 59.5 years, and 171 (65.8%) and 89 (34.2%) of them were males and females, respectively. CVD was more prevalent in males than females (65.8% vs. 34.2%), and systemic hypertension (HTN) was the most common risk factor in patients (55.4%), followed by diabetes (26.5%). The mean BMI of patients was 28.24 kg/m2 and there was no association between obesity grading and the other risk factors of CAD. In addition, no significant associations were observed between BMI and the values of syntax score I and clinical SYNTAX score (CSS) (P=0.254 and 0.101, respectively), as well as obesity grading and syntax score II treatment recommendation based on the syntax score II (Chi-square value = 7.67, P=0.661).

In patients with stable angina who are candidates for angiography, the severity of coronary artery involvement was not different according to syntax scores I and II and the clinical syntax score in different BMI groups under the same conditions in terms of other risk factors for CAD.