SynthesisEuropean journal of epidemiology2014
The obesity paradox in acute coronary syndrome: a meta-analysis.
Synthesis in European journal of epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 145 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
145 citing papers in PubMed, 9 syntheses or guidelines pooled it, 267 citations in OpenAlex.
- Influence of Obesity on the Safety and Efficacy of Antithrombotic Therapy: A Systematic Review and Meta-Analysis.Arquivos brasileiros de cardiologia · 2025Pooled it
- The impact of body mass index on mortality rates of hip fracture patients: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Temporal Associations Among Body Mass Index, Fasting Insulin, and Systemic Inflammation: A Systematic Review and Meta-analysis.JAMA network open · 2021Pooled it
- Association Between Obesity and Cardiovascular Outcomes: Updated Evidence from Meta-analysis Studies.Current cardiology reports · 2020Pooled it
- Association Between Obesity and Cardiovascular Outcomes: A Systematic Review and Meta-analysis of Mendelian Randomization Studies.JAMA network open · 2018Pooled it
- The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis.BMC anesthesiology · 2017Pooled it
- Pooled it
- Increased body mass index and adjusted mortality in ICU patients with sepsis or septic shock: a systematic review and meta-analysis.Critical care (London, England) · 2016Pooled it
- Adipokines and Migraine: A Systematic Review.Headache · 2016Pooled it
- Overweight predisposes to microvascular obstruction: insights from the TATORT-NSTEMI trial.The international journal of cardiovascular imaging · 2026Trial
- Associations of General and Central Obesity with Cardiovascular Risk by Menopausal and MASLD Status.Biomedicines · 2026Article
- Nutritional Status and Obesity Paradox in Acute Coronary Syndrome Patients.Journal of cardiovascular development and disease · 2026Article
- Muscle Mass Is a Better Predictor of Survival in Dogs With Chronic Kidney Disease Compared to Body Condition Score.Journal of animal physiology and animal nutrition · 2026Article
- Adipokine-mediated metabolic responses across BMI in acute myocardial infarction.BMC cardiovascular disorders · 2026Article
- Age-dependent obesity paradox in acute myocardial infarction prognosis: a cohort study of body mass index and recurrent myocardial infarction.International journal of obesity (2005) · 2026Article
- Weight change and long-term cardiovascular outcomes in overweight and obese patients after acute coronary syndromes.European heart journal open · 2026Article
- Association of low body mass index with the risk of major adverse cardiovascular events among patients with acute myocardial infarction: a single-center cohort study from Iran.BMC cardiovascular disorders · 2026Article
- Article
- A 6-year cohort study of the associations of body mass index, waist circumference, and waist-hip ratio with cognitive impairment in Chinese elderly.Frontiers in psychology · 2026Article
- Advanced lung cancer inflammation index and all-cause mortality in critically ill patients with sepsis: analysis of the MIMIC-IV database.BMC infectious diseases · 2025Observational
85 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the general population, the lowest mortality risk is considered to be for the body mass index (BMI) range of 20-24.9 kg/m(2). In chronic diseases (chronic kidney disease, chronic heart failure or chronic obstructive pulmonary disease) the best survival is observed in overweight or obese patients. Recently above-mentioned phenomenon, called obesity paradox, has been described in patients with coronary artery disease. Our aim was to analyze the relationship between BMI and total mortality in patients after acute coronary syndrome (ACS) in the context of obesity paradox. We searched scientific databases for studies describing relation in body mass index with mortality in patients with ACS. The study selection process was performed according to PRISMA statement. Crude mortality rates, odds ratio or risk ratio for all-cause mortality were extracted from articles and included into meta-analysis. 26 studies and 218,532 patients with ACS were included into meta-analysis. The highest risk of mortality was found in Low BMI patients--RR 1.47 (95 % CI 1.24-1.74). Overweight, obese and severely obese patients had lower mortality compared with those with normal BMI-RR 0.70 (95 % CI 0.64-0.76), RR 0.60, (95 % CI 0.53-0.68) and RR 0.70 (95 % CI 0.58-0.86), respectively. The obesity paradox in patients with ACS has been confirmed. Although it seems to be clear and quite obvious, outcomes should be interpreted with caution. It is remarkable that obese patients had more often diabetes mellitus and/or hypertension, but they were younger and had less bleeding complications, which could have influence on their survival.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.