Central Obesity in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Prevalence, Clinical Correlates, and In-Hospital Outcomes

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (n=1099). Intervention: Central obesity (waist circumference ≥90 cm in men and ≥80 cm in women) vs. Non-central obesity (waist circumference <90 cm in men and <80 cm in women). Primary outcome: In-hospital mortality (p=0.466).

Q: What does this research mean for the field?

Central obesity is highly prevalent among STEMI patients undergoing primary percutaneous coronary intervention but does not significantly influence in-hospital mortality or short-term adverse outcomes. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Rajesh Kumar; Lajpat Rai; Syed Zohaib Ahsan; Bilal Akhtar; Jaghat Ram; Muhammad Owais Shahid; Shaheer Khan Muhammad; Neelam Anees; Ali Hyder; Sumaira Fareed Khan; Haya Jawaid; Nasir Yaqoob; Bisma Jalil; Shitba Naeem; Abdul Fatah Tunio; Abiha Urooj; Jamil Ur Rahman; Rabia Adab; Uroosa Safdar

doi:10.47144/phj.v59i5.3161

Key result

Central obesity was present in 68.7% of STEMI patients undergoing primary PCI but did not significantly affect in-hospital mortality compared with non-obese patients (2.8% vs. 2.0%; p=0.466).

Why the study?

Does central obesity increase the risk of in-hospital mortality and post-procedural complications in patients with STEMI undergoing primary PCI?

Key Points

To determine the prevalence of central obesity, evaluate its clinical correlates, and assess its impact on in-hospital outcomes in patients presenting with STEMI undergoing primary PCI.
Prospective cohort study of 1,099 patients presenting with STEMI undergoing primary PCI (78.0% male, mean age 54.66 ± 10.9 years).
Central obesity was defined using waist circumference thresholds of ≥90 cm in men and ≥80 cm in women.
Adverse clinical outcomes, including in-hospital mortality and procedural complications, were compared between centrally obese (n=755) and non-obese (n=344) patients.
Central obesity was present in 68.7% (n=755) of patients, who had a higher prevalence of general obesity (72.7% vs. 38.4%; p<0.001) and a lower prevalence of smoking (21.7% vs. 27.9%; p=0.025).
In-hospital mortality showed no statistically significant difference between centrally obese and non-obese patients (2.8% [21/755] vs. 2.0% [7/344]; p=0.466).
Heart failure occurred in 5.6% of centrally obese vs. 8.4% of non-obese patients (p=0.073), and central obesity was not an independent multivariable predictor of in-hospital mortality.

Study Design

Type

Cohort (n=1,099)

Multicenter

No

Structured PICO

Does central obesity increase the risk of in-hospital mortality and post-procedural complications in patients with STEMI undergoing primary PCI?

P

Population

1,099 adults (mean age 54.66 years, 22.0% female) presenting with STEMI undergoing primary PCI without pre-existing chronic kidney disease, followed during hospitalization.

E

Exposure

Central obesity (exposure), defined as waist circumference ≥90 cm in men and ≥80 cm in women (n=755, 68.7%)

C

Comparator

Non-central obesity, defined as waist circumference <90 cm in men and <80 cm in women (n=344, 31.3%)

O

Outcome

In-hospital mortality and post-procedural complications including heart failure (pump failure, defined as LVEF ≤40%), contrast-induced nephropathy (CIN, defined as ≥25% or ≥0.5 mg/dL increase in serum creatinine within 72 hours), stroke (new-onset neurological deficit during hospitalization), major bleeding (BARC ≥3), access site complications, and slow flow/no-reflow phenomena (TIMI flow grade <III) during hospitalizationhard clinical

Main Result

Absolute Event Rate: 2.8% vs 2%

p-value: p=0.466

Although central obesity is present in over two-thirds of South Asian patients undergoing primary PCI for STEMI, it does not independently impact short-term in-hospital mortality or procedural complications.

Limitations

Observational study design precludes establishing causal relationships
Single-center study limiting generalizability
Consecutive sampling approach may have introduced selection bias
Exclusion of patients with missing waist circumference data may have introduced attrition bias
Lack of long-term follow-up data beyond hospitalization
Potential residual confounding from unmeasured variables such as treatment quality or medication adherence
Observational design precludes the establishment of causal relationships
Possibility of residual confounding from unmeasured variables

Implication

Central obesity not linked to higher in-hospital mortality after primary PCI for STEMI; leaves open its prognostic value in prospective cohorts.

Abstract

Objectives: Central obesity (CO), characterized by excess abdominal adiposity, is a well-established cardiovascular risk factor. However, its specific clinical implications in patients presenting with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remain insufficiently defined. This study aimed to determine the prevalence of CO, evaluate its associated clinical characteristics, and assess its impact on in-hospital outcomes in this high-risk population. Methodology: This prospective cohort study included patients presenting with STEMI who underwent primary PCI. Central obesity was defined using waist circumference thresholds of ≥90 cm in men and ≥80 cm in women [10]. Patients were followed throughout their hospital stay for the occurrence of adverse clinical outcomes, including mortality and procedural complications. Results: A total of 1,099 patients were enrolled, of whom 78.0% (n=857) were male, with a mean age of 54.66 ± 10.9 years. Central obesity was present in 68.7% (n=755) of patients. The prevalence of CO was comparable between females and males (73.6% vs. 67.3%; p=0.065). Patients with CO had a significantly higher prevalence of general obesity (72.7% vs. 38.4%; p<0.001) and a lower prevalence of smoking (21.7% vs. 27.9%; p=0.025). There were no statistically significant differences in in-hospital mortality (2.8% vs. 2.0%; p=0.466) or heart failure rates (5.6% vs. 8.4%; p=0.073) between centrally obese and non-obese patients. Conclusion: Central obesity is highly prevalent among patients with STEMI undergoing primary PCI and is strongly associated with general obesity. However, it does not appear to significantly influence short-term in-hospital outcomes. These findings highlight the need for a nuanced understanding of obesity-related risk in acute cardiovascular care.

Discussion

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Cite This Study

Kumar et al. (2026) conducted a cohort in ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (n=1,099). Central obesity (waist circumference ≥90 cm in men and ≥80 cm in women) vs. Non-central obesity (waist circumference <90 cm in men and <80 cm in women) was evaluated on In-hospital mortality (p=0.466). Central obesity was present in 68.7% of STEMI patients undergoing primary PCI but did not significantly affect in-hospital mortality compared with non-obese patients (2.8% vs. 2.0%; p=0.466).

synapsesocial.com/papers/6ae92596a8a6b2adf62f5fe9 https://doi.org/10.47144/phj.v59i5.3161

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Central Obesity in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Prevalence, Clinical Correlates, and In-Hospital Outcomes

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Central Obesity in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Prevalence, Clinical Correlates, and In-Hospital Outcomes

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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