What is the clinical evidence from this study?

Study design: Observational. Population: non-ST-elevation myocardial infarction (NSTEMI) (n=3597279). Intervention: Overweight vs. Normal weight. Primary outcome: Mortality (OR 0.49, 95% CI 0.41-0.59, p=<0.001).

What does this research mean for the field?

In patients with non-ST-elevation myocardial infarction, being overweight or obese is associated with significantly lower in-hospital mortality compared to normal weight, whereas cachexia is associated with markedly increased mortality. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 1, 2025Heart ViewsOpen Access

Obesity Paradox Occurs in Non-ST-elevation Myocardial Infarction for Overweight and Obesity but Not for Morbid Obesity

Q: What are the key findings of this study?

In patients with NSTEMI, being overweight was associated with lower mortality compared to normal weight (3.2% vs 7.8%; OR 0.49, 95% CI 0.41-0.59, P<0.001).

Q: What does this research mean for the field?

In patients with non-ST-elevation myocardial infarction, being overweight or obese is associated with significantly lower in-hospital mortality compared to normal weight, whereas cachexia is associated with markedly increased mortality. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Overweight status linked to ~51% lower NSTEMI mortality vs. normal weight.

OR 0.49
95% CI 0.41-0.59
P<0.001
n=3,597,279

Why the study?

The obesity paradox has been observed in cardiovascular disease, but whether obesity has a protective effect in patients presenting with NSTEMI remained to be evaluated.

Population

3,597,279 NSTEMI patients over the age of 18 years

Comparison

Mortality across weight categories (overweight, obesity, morbid obesity, normal weight, and cachexia)

Design

Retrospective database study using the Nationwide Inpatient Sample

Authors

MHMehrtash HashemzadehUniversity of Arizona AAAmir Parsa AbhariIsfahan University of Medical Sciences MMMohammad Reza MovahedUniversity of Arizona

Discussion

Member takes

Implication

Caution against assuming protective obesity effect in NSTEMI; leaves open confounding and causality for prospective study.

Study Design

Type

Observational (n=3,597,279)

Multicenter

Yes

PICO

Population

3,597,279 adults (≥18 years) with NSTEMI evaluated to assess the association between weight categories and mortality.

Exposure / Comparator

Overweight vs Normal weight

Primary Outcome

Mortality — OR 0.49 (0.41-0.59), p=<0.001

Main Result

Odds Ratio: 0.49 (95% CI 0.41–0.59)

Absolute Event Rate: 3.2% vs 7.8%

p-value: p=<0.001

Cite This Study

Hashemzadeh et al. (2025) conducted an observational in non-ST-elevation myocardial infarction (NSTEMI) (n=3,597,279). Overweight vs. Normal weight was evaluated on Mortality (OR 0.49, 95% CI 0.41-0.59, p=<0.001). In patients with NSTEMI, being overweight was associated with lower mortality compared to normal weight (3.2% vs 7.8%; OR 0.49, 95% CI 0.41-0.59, P<0.001).

synapsesocial.com/papers/6a83fbf953408ed95e4d9352 https://doi.org/10.4103/heartviews.heartviews_98_25

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Obesity Paradox Occurs in Non-ST-elevation Myocardial Infarction for Overweight and Obesity but Not for Morbid Obesity

Discussion

Member takes

Implication

Study Design

PICO

Main Result

Cite This Study

Obesity Paradox Occurs in Non-ST-elevation Myocardial Infarction for Overweight and Obesity but Not for Morbid Obesity

Discussion

Member takes

Implication

Study Design

PICO

Main Result

Cite This Study

Also Consider

Also Consider