The Relationship Between Obesity Paradox and Inflammation Markers in STEMI Short: Obesity Paradox in STEMI

Objectives: Inflammation plays a very important role in the pathogenesis of coronary artery disease (CAD) and its prognosis. Especially; C-reactive protein (CRP) is associated with poor prognosis in patients with CAD. In this study, the relationship between CRP levels and body mass ındex (BMI) was investigated in patients who underwent primary coronary intervention (PCI) due to ST elevation myocardial infarction (STEMI). Methods: Between January 2015 and February 2016, 132 patients who underwent PCI due to acute STEMI were included in the retrospective study. Patients were classified into two groups: (Group 1: BMI <25 kg/m 2 n=27 and BMI >35 kg/m 2 n=9, total: 36 patients; Group 2: 25 <BMI <30 kg/m 2 n=58 and 30 <BMI <35 kg/ m 2 n=38, total 96 patients). Class 2, 3 obese patients and normal weight patients constituted Group 1 whereas pre-obese and Class 1 obese patients were included in Group 2. The patients are grouped in this way because the prognosis of the first group is worse in obesity paradox studies. Results: There was no statistically significant difference between the two groups regarding demographic features, risk factors and left ventricular ejection fraction. CRP was significantly higher in group 1 (p=0.004). Among the inflammation markers, only CRP was significantly higher in Group 1. Conclusion: CRP was found to be significantly lower in STEMI patients with 25 >BMI <35. Whereas, it was significantly higher in STEMI patients with 25 <BMI >35. One of the reasons for the better prognosis of mildly overweight and Class 1 obese patients with STEMI diagnosis may be the low values of CRP which has many effects on atherosclerotic plaque formation.