Impact of body mass index on clinical outcomes following percutaneous coronary intervention in young adults with non-ST-elevation myocardial infarction

Objectives: Body mass index (BMI) is an important risk factor for cardiovascular disease and is associated with the development of coronary artery disease (CAD). However, the relationship between BMI and clinical outcomes following percutaneous coronary intervention (PCI) after acute non-ST-elevation myocardial infarction (NSTEMI) remains a matter of debate. The “Obesity Paradox” suggests that overweight or obese patients may have better outcomes than normal-weight individuals. This study aimed to evaluate the impact of BMI and clinical outcomes following PCI in young adults (≤40 years) with acute NSTEMI. Material and Methods: This observational cross-sectional study included 120 consecutive patients aged <40 years who underwent PCI following NSTEMI. Patients were classified according to World Health Organisation BMI criteria: underweight (<18.5 kg/m 2 ), normal (18.5–24.9 kg/m 2 ), overweight (25–29.9 kg/m 2 ), and obese (≥30 kg/m 2 ). Demographics, cardiovascular risk factors, echocardiographic findings, angiographic data, procedural characteristics, and in-hospital outcomes were analysed. Results: The population was predominantly male (90%). BMI distribution was normal 56.6%, overweight 26.7%, obese 10.0%, and underweight 6.7%. Hypertension (65.0%), diabetes mellitus (48.3%), and smoking (50.0%) were common. Overweight patients had a higher prevalence of diabetes (62.5%) and dyslipidaemia (62.5%). The mean left ventricular ejection fraction was preserved. Coronary angiography revealed single-vessel disease in 39 (32.5%), double-vessel in 30 (25.0%), and triple-vessel in 25 (20.8%) patients. PCI was performed as a single-vessel in 79 (65.8%), double-vessel in 24 (20.0%), and triple-vessel in 17 (14.2%) patients. In-hospital outcomes were favourable; one death occurred in an overweight patient due to cardiogenic shock with multi-organ dysfunction. No statistically significant differences were observed between BMI groups for angiographic severity, PCI type, or in-hospital outcomes. Conclusion: Young adults with Acute NSTEMI undergoing PCI demonstrated favourable in-hospital outcomes. We found that BMI was not significantly associated with differences in angiographic severity, procedural characteristics, or short-term clinical outcomes.