JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
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Original Article
The relationship between obesity paradox and C-reactive protein in patients with st-segment-elevation myocardial infarctions
Abstract
Aims: 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 BMI was investigated in patients who underwent primary coronary intervention (PCI) due to ST-segment elevation myocardial infarction (STEMI).
Methods: Between January 2015 and February 2016, 132 patients who underwent primary coronary intervention due to acute STEMI were included in the retrospective study. Patients were classified into two groups: (Group 1:BMI<25kg/m2 n:27 and BMI>35 kg/m2 n:9, total:36 patients; Group2: BMI>25 and BMI<30 kg/m2 n:58 and BMI>30 and BMI<35 kg/m2 n:38, total 96 patients). Class 2,3 obese patients and normal weight patients constituted Group 1 where as pre-obese and class 1 obese patients were included in Group2. The patients are grouped in this way because the prognosis of the first group is worse in obesity paradox studies.
Results: CRP was found to be significantly lower in STEMI patients with BMI>25 and BMI<35. Whereas it was significantly higher in STEMI patients with BMI>25 and BMI<35.
Conclusion: In this study, the relationship between CRP levels and BMI was investigated in patients who underwent primary coronary intervention (PCI) due to ST elevation myocardial infarction (STEMI). 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.

Keywords : ST-segment elevation myocardial infarction, C-reactive protein, obesity paradox

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1. Skinner AC, Perrin EM, Skelton JA. Prevalence of obesity and severe obesity in US children, 1999-2014. Obesity (Silver Spring). 2016;24(5): 1116-1123. doi:10.1002/oby.21497
2. Lavie CJ, De Schutter A, Parto P, et al. Obesity and prevalence of cardiovascular diseases and prognosis-theobesity paradox updated. Prog Cardiovasc Dis. 2016;58(5):537-547. doi:10.1016/j.pcad.2016.01.008
3. Lavie CJ, De Schutter A, Milani RV. Healthy obese versus unhealthy lean: theobesity paradox. Nat Rev Endocrinol. 2015;11(1):55-62. doi:10. 1038/nrendo.2014.165
4. Park DW, Kim YH, Yun SC, et al. Association of body mass index with major cardiovascular events and with mortality after percutaneouscoronary intervention. Circ Cardiovasc Interv. 2013;6(2): 146-153. doi:10.1161/CIRCINTERVENTIONS.112.000062
5. Herrmann J, Gersh BJ, Goldfinger JZ, et al. Body mass index and acute and long-term outcomes after acute myocardial infarction (from the harmonizing outcomes with revascularizationand stents in acute myocardial infarction trial). Am J Cardiol. 2014;114(1):9-16. doi:10.1016/ j.amjcard.2014.03.057
6. Niedziela J, Hudzik B, Niedziela N, et al. The obesity paradoxin acute coronary syndrome: a meta-analysis. Eur J Epidemiol. 2014;29(11):801-812. doi:10.1007/s10654-014-9961-9
7. Ross R. Atherosclerosis is an inflammatory disease. Am Heart J. 1999; 138(5 Pt 2):S419-420. doi:10.1016/s0002-8703(99)70266-8
8. Kinjo K, Sato H, Ohnishi Y, et al. Impact of high-sensitivity C-reactive protein on predicting long-term mortality of acute myocardial infarction. Am J Cardiol. 2003;91(8):931-935. doi:10.1016/s0002-9149(03) 00106-1
9. Lindahl B, Toss H, Siegbahn A, Venge P, Wallentin L. Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. FRISC study group. Fragmin during Instability in coronary artery disease. N Engl J Med. 2000;343(16):1139-1147. doi:10.1056/NEJM200010193431602
10. Mora S, Ridker PM. Justification for the use of statins in primary prevention: an intervention trial evaluating rosuvastatin (JUPITER)-can C-reactive protein be used to target statin therapy in primary prevention? Am J Cardiol. 2006;97(2A):33A-41A. doi:10.1016/j.amjcard. 2005.11.014
11. Ridker PM, Cannon CP, Morrow D, et al. Pravastatin or atorvastatin evaluation and infection therapy thrombolysis in myocardial infarction. N Engl J Med. 2005;352:20-28. doi:10.1056/NEJMoa042378
12. Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006;368(9536):666-678. doi:10.1016/S0140-6736(06)69251-9
13. Neeland IJ, Das SR, Simon DN, et al. The obesity paradox, extreme obesity, and long-term outcomes in older adults with ST-segment elevation myocardial infarction: results from the NCDR. Eur Heart J Qual Care Clin Outcomes. 2017;3(3):183-191. doi:10.1093/ehjqcco/qcx010
14. Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107(3):363-369. doi: 10.1161/01.cir.0000053730.47739.3c
15. Whiteley W, Jackson C, Lewis S, et al. Inflammatory markers and poor outcome after stroke: a prospective cohort study and systematic review of interleukin-6. PLoS Med. 2009;6(9):e1000145. doi:10.1371/journal.pmed.1000145
16. Zakynthinos E, Pappa N. Inflammatory biomarkers in coronary artery disease. J Cardiol. 2009;53(3):317-33. doi:10.1016/j.jjcc.2008.12.007
17. Fu T, Borensztajn J. Macrophage uptake of low-density lipoprotein bound to aggregated C-reactive protein: possible mechanism of foam-cell formation in atherosclerotic lesions. Biochem J. 2002;366(Pt 1):195-201. doi:10.1042/BJ20020045
18. Morrow DA, Kaski CJ, Downey CB. C-reactive protein in cardiovascular disease. Uptodate Literature review current through: December 2015.
19. Oltrona L, Ottani F, Galvani M; Italian working group on atherosclerosis, thrombosis, and vascular biology and the associazione nazionale medici cardiologi ospedalieri (ANMCO). Clinical significance of a single measurement of troponin-I and C reactive protein at admission in 1773 consecutive patients with acute coronary syndromes. Am Heart J. 2004; 148(3):405-415. doi:10.1016/j.ahj.2004.03.023
20. Kruk M, Przyluski J, Kalinczuk L, et al. Association of non-specific inflammatory activation with early mortality in patients with ST-elevation acute coronary syndrome treated with primary angioplasty. Circ J. 2008;72(2):205-211. doi:10.1253/circj.72.205
21. Dedobbeleer C, Melot C, Renard M. C-reactive protein increase in acute myocardial infarction. Acta Cardiol. 2004;59(3):291-296. doi:10.2143/AC.59.3.2005184
22. Koyama K, Yoneyama K, Mitarai T, et al. Association between inflammatory biomarkers and thin-cap fibroatheroma detected by optical coherence tomography in patients with coronary heart disease. Arch Med Sci. 2015;11(3):505-512. doi:10.5114/aoms.2015.52352
23. Koskinas KC, Zaugg S, Yamaji K, et al. Changes of coronary plaque composition correlate with C-reactive protein levels in patients with ST-elevation myocardial infarction following high-intensity statin therapy. Atherosclerosis. 2016;247(100):154-160. doi:10.1016/j.atherosclerosis. 2016.02.015
24. Fang H, Judd RL. Adiponectin regulation and function. Compr Physiol. 2018;8(3):1031-1063. doi:10.1002/cphy.c170046
25. Tao L, Gao E, Jiao X, et al. Adiponectin cardioprotection after myocardial ischemia/reperfusion involves the reduction of oxidative/nitrative stress. Circulation. 2007;115(11):1408-1416. doi:10.1161/CIRCULATIONAHA.106.666941
26. Zhang HL, Jin X. Relationship between serum adiponectin and osteoprotegerin levels and coronary heart disease severity. Genet Mol Res. 2015;14(3):11023-11029. doi:10.4238/2015.September.21.15
27. Xia K, Guo L, Zhao Z, Md Sayed AS, Li F, Yang T. Plasma level of adiponectin in coronary heart disease patients combined with abnormal glucose metabolism. Zhong nan da xue xue bao. Yi xue ban= Journal of Central South University. Med Sci. 2012;37(2):179-184. doi:10.3969/j.issn.1672-7347.2012.02.012
Article available in :
Volume 3, Issue 1, 2025
Page : 1-4
https://doi.org/10.51271/JCCVS-0047
Article Information
Received : 28 Şub 2024
Accepted : 12 Ara 2024
Published : 27 Mar 2025
Corresponding Author :

Gamze Yeter Arslan: Department of Cardiology, Kepez State Hospital, Antalya, Turkiye

[email protected]
Citation : Arslan GY, Toprak C, Karataş M, Soner S. The relationship between obesity paradox and C-reactive protein in patients with ST-segment-elevation myocardial infarctions. J Cardiol Cardiovasc Surg. 2025;3(1):1-4.

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