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Abstract

Background:

Obesity is a major public health concern. We sought to investigate temporal trends in characteristics and outcomes of acute coronary syndrome patients according to body mass index.

Methods:

The study population consisted of patients who were included in the Acute Coronary Syndromes Israeli Surveys during 2000–2016. Patients were categorised into three groups according to body mass index: below 25 kg/m², 25–30 kg/m² (overweight) and above 30 kg/m² (obese). Among each body mass index group the outcomes of two time frames were compared – early (2000–2006) versus late (2008–2016).

Results:

Overall 12,167 patients were included. Between the years 2000 and 2016, the percentage of obese patients increased from 20% to 30%. Obese patients were more frequently selected for an invasive approach, and had the lowest all-cause mortality rates. A significant reduction in 1-year mortality in recent compared to early surveys among patients with body mass index less than 25 kg/m² and in obese patients but not for overweight patients was shown. Multivariable analysis showed that body mass index greater than 25 kg/m² was associated with 30% lower 1-year mortality (hazard ratio 0.70, 95% confidence interval 0.55–0.90, P=0.005).

Conclusion:

The prevalence of obesity among acute coronary syndrome patients has increased over the past two decades. A reduction of all-cause mortality was mainly seen in lean and obese patients.

Keywords

BMI temporal trends ACS outcomes obesity

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Temporal trends in management and outcomes of patients with acute coronary syndrome according to body mass index