Key result
Higher body mass index was inversely associated with adverse in-hospital outcomes after percutaneous coronary intervention (OR 0.95), with underweight and normal-weight patients experiencing higher complication rates (22.0% vs 6.0%).
Why the study?
The existence of the obesity paradox and its impact on short-term clinical outcomes after PCI have not been thoroughly investigated, especially in Bangladesh.
Does higher BMI improve short-term in-hospital outcomes in patients undergoing PCI?
Cross-Sectional (n=100)
No
Does higher BMI improve short-term in-hospital outcomes in patients undergoing PCI?
Higher BMI is associated with a lower risk of short-term in-hospital adverse clinical outcomes and shorter hospital stays following PCI, supporting the existence of an obesity paradox in this population.
Answers are grounded in this paper and cite their sources.
Supports obesity paradox in short-term PCI outcomes in Bangladeshi cohort; leaves open whether BMI informs risk stratification pending prospective studies.
Background: The “obesity paradox”, a counterintuitive decrease in morbidity and mortality with increasing body mass index (BMI), has been shown in patients when acute cardiovascular decompensation occurs. However, whether this phenomenon exists in patients undergoing percutaneous coronary intervention (PCI) is not well known. The existence of obesity paradox and its impact on short-term clinical outcomes after PCI have not been thoroughly investigated, especially in Bangladesh. Methods: This cross-sectional observational study was conducted at National Institute of Cardiovascular Diseases, Dhaka, in 100 patients who underwent PCI. They were divided in two groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI <23.0 kg/m2). Short-term in-hospital outcomes after PCI were observed and recorded. Results: Acute left ventricular failure (LVF) was found to be statistically significant between groups (p < 0.01) being higher in Group-I. The difference of mean duration of hospital stay (LOS) after PCI was higher in the same group which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse in hospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 – 2.24 and 1.16 – 1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with in-hospital outcomes after PCI (OR = 0.95; 95% CI = 0.91 – 0.98; p = 0.007). Conclusion: The results of the study uphold the phenomenon of the “obesity paradox” following PCI. The underweight and normal weight people are at greater risk to experience short-term in-hospital adverse clinical outcomes than overweight and obese people after PCI. Bangladesh Heart Journal 2021; 36(1): 1-8
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Siddiqui et al. (2021) conducted a cross-sectional in Coronary Artery Disease (n=100). Body mass index (BMI) vs. Normal/underweight (BMI < 23 kg/m2) vs Overweight/obese (BMI ≥ 23 kg/m2) was evaluated on Adverse in-hospital outcomes (OR 0.95, 95% CI 0.91-0.98, p=0.007). Higher body mass index was inversely associated with adverse in-hospital outcomes after percutaneous coronary intervention (OR 0.95), with underweight and normal-weight patients experiencing higher complication rates (22.0% vs 6.0%).
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