Shah M, et al. - Using the 2005-14 Nationwide Inpatient Sample, a total of 54,044 adult cases of cardiogenic shock (CS) accompanying acute coronary syndrome were reviewed to gauge outcomes among patients who were non-obese, obese [body mass index (BMI) 30.0-39.9 kg/m²] and extremely-obese (BMI ≥40 kg/m²). Effect on in-hospital mortality was determined in a multivariate analysis. Among patients who were obese and extremely-obese, 3,602 (6.6%) and 1,610 (2.9%) admissions were documented. Obese and extremely-obese vs non-obese were younger but had significantly higher comorbidity burden. An associated ST-elevation myocardial infarction was most likely to be seen in CS patients who were not-obese vs the obese and extremely-obese. Higher rates of percutaneous coronary intervention [PCI] and coronary artery bypass grafting [CABG] were observed in obese vs non-obese whereas those extremely-obese had higher CABG rates but similar PCI rates. Lower and higher in-hospital mortality was predicted by obesity and extreme-obesity, respectively, compared to the non-obese.