Obesity is a critical risk factor for cardiovascular disease, specifically ST-segment elevation myocardial infarction (STEMI), and may influence clinical presentation, laboratory findings, and patient outcomes.

Aim. To identify clinical and laboratory features and evaluate the disease course in patients with acute coronary syndrome and ST segment elevation across different body mass index (BMI) categories.

Materials and methods. A non-randomized, open-label, prospective cohort study was conducted involving 120 patients with STEMI. Participants were categorized into three groups based on their BMI.

Results. In the obese group, a strong positive correlation was observed between troponin I levels and BMI (r = 0.632, t = 5.29, p < 0.001). A moderate correlation was found in the overweight group (r = 0.402, t = 2.86, p < 0.01). Furthermore, a statistically significant positive correlation between BMI and erythrocyte sedimentation rate (ESR) was identified in both the obese group (r = 0.663, t = 5.74, p < 0.001) and the overweight group (r = 0.312, t = 2.09, p = 0.042).

Conclusions. Obese patients demonstrated a more severe and clinically pronounced course of STEMI at the time of diagnosis and admission. Increased BMI was significantly associated with poorer STEMI outcomes, as evidenced by marked elevations in troponin I, ESR, respiratory rate, and heart rate in the obese cohort.