Sunday, June 24, 2007


The latest online (20th June) European Heart Journal carried a very interesting article by Dr Heinz Buettner and colleagues who showed that obese and very obese patients do better and live longer after PCI for acute coronary syndrome.

Conversely, it is true that obese patients run a higher risk of hypertension and diabetes, often resulting in coronary artery disease, and acute coronary syndrome. Once the obese patient develops acute coronary syndrome,and undergo PCI, the more obese you are, the better your in-hospital and also better 1 year mortality.

How amazing. Now my obese patients may turn around and tell me that it is better to be fat. I certainly do not know how to explain these findings. In fact this latest findings in the 20th June, follows another piece of work which was reported essentially the same findings. The on-going BARI trial may shed some light into this findings. I know that whenever we have to intervene in an obese patient, we fear as they post great technical challenges due to their size, and also even greater challenge should we have to resuscitate them should the need arises. We hope that this interesting finding will be collaborated by other workers. In the meantime, we should continue to advice a strategy of diet and exercise, to lose weight. There are many paradoxes in medical science, but this must stand as one of the most paradoxical of them all.

It does not mean it's ok to be fat.

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