Comparison of Clinical and Angiographic Profile and Short-term Outcomes in Obese and Nonobese Patients with Acute Coronary Syndrome

Background: Obesity has reached epidemic proportions in India in the 21 st century. Whether obesity is an individual factor affecting patients with acute coronary syndrome (ACS) is unknown. This study was done to compare and evaluate the profile of obese and nonobese patients with ACS and observe their short-term outcomes. Materials and Methods: A prospective, observational study was conducted among 300 patients; 138 patients were obese and 162 patients were nonobese based on body mass index (BMI). For all eligible patients, clinical, personal, and family history were collected. The Rose questionnaire was used to identify ischemic heart pain. P < 0.05 was considered statistically significant. Results: Obese patients exhibited significantly higher rates of diabetes (52.2% vs. 37.7%, P = 0.012), hypertension (47.1% vs. 30.2%, P = 0.003), and dyslipidemia (67.4% vs. 50.6%, P = 0.003) compared to nonobese patients. Nonobese patients presented more frequently with ST-segment elevation myocardial infarction (69.8% vs. 55%, P = 0.030). Angiographic findings and coronary artery involvement were comparable between groups. At 6-month follow-up, no statistically significant differences were observed in major adverse cardiac events between obese and nonobese patients. Conclusion: This study demonstrates that while obese patients with ACS have a higher prevalence of metabolic risk factors, their short-term outcomes are comparable to nonobese patients. These findings challenge the “obesity paradox” in this South Asian population and emphasize the need for tailored risk assessment and management strategies in patients with ACS across different BMI categories.