Table of Contents
ISRN Obesity
Volume 2014, Article ID 634717, 7 pages
Research Article

Atherosclerosis Burden in Patients with Acute Chest Pain: Obesity Paradox

1Department of Medicine, The Methodist Hospital, Houston, TX 77030, USA
2Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, TX 77030, USA

Received 15 September 2013; Accepted 21 October 2013; Published 12 January 2014

Academic Editors: K.-C. Huang and J. Saleh

Copyright © 2014 Kongkiat Chaikriangkrai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Obesity paradox has been described in various populations of coronary artery disease, mainly asymptomatic subjects. However, relationship between obesity and coronary artery calcification detected by cardiac CT in symptomatic patients has rarely been demonstrated. This study seeks to investigate whether the paradoxical relationship between obesity and coronary artery calcification exists in patients with acute chest pain. A final cohort of 1030 chest pain patients presenting at our emergency department who underwent coronary evaluation by multidetector cardiac CT were examined. With absent-to-mild coronary calcification (CAC score < 100) as a referent, multivariable analysis showed that presence of obesity (OR 0.564; 95% CI 0.395, 0.806; 0.002), body mass index (OR 0.945; 95% CI 0.920, 0.971; ), body weight (OR 0.987; 95% CI 0.979, 0.995; 0.001), and body surface area (OR 0.582; 95% CI 0.369, 0.920; 0.020) were inversely associated with moderate-to-severe coronary calcification (CAC score ≥ 100). This study extends the concept of obesity paradox to symptomatic patients undergoing coronary artery calcium score assessment. However, biological explanation(s) of this paradox remains unanswered.