Abstract 224: Obesity Paradox in Coronary Artery Disease in Patients With Acute Chest Pain

Introduction Obesity has been inconsistently linked with coronary artery calcium score (CACS) as a surrogate of coronary artery disease (CAD) in asymptomatic subjects. Our aim was to examine whether there is relationship between obesity defined by BMI≥30kg/m 2 and presence and severity of CAD defined by CACS in patients with acute chest pain. Methods In this cross-sectional study, 1030 consecutive patients without reported history of coronary artery disease who presented with acute chest pain were included. CACS by non-contrast CT scan and BMI were collected. Patients were categorized by CACS classifications and BMI. Results The population with mean age of 54±13 years, 33% (338 of 1030) of patients being overweight and 46% (477 of 1030) being obese consisted of 60.6% (624 of 1030) patients with zero CACS, 21.7% (223 of 1030) with mild calcification (0<CACS<100) and 17.8% (183 of 1030) with moderate-to-severe calcification (CACS≥100). Compared to non-overweight/non-obese group, obese group had less patients with moderate-to-severe calcification (69 of 477; 14.5% VS 50 of 215; 22.6% p-value=0.016) despite more patients with hypertension (311 of 477; 65.2% VS 98 of 215; 45.6% p-value<0.001), diabetes (98 of 477; 20.5% VS 11 of 215; 5.1% p-value<0.001) and hyperlipidemia(174 of 477; 36.5% VS 57 of 215; 26.5% p-value=0.010). Obesity is INVERSELY associated with presence of CACS and moderate-to-severe calcification in multivariable logistic regression analysis (table 1). Conclusion Obesity defined by body mass index ≥ 30kg/m 2 is INVERSELY associated with presence and severity of coronary artery disease defined by coronary artery calcium score in patients with acute chest pain.