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. 2025 Feb 10:14:100167.
doi: 10.1016/j.obpill.2025.100167. eCollection 2025 Jun.

Impact of metabolically healthy obesity on post percutaneous coronary intervention outcomes in patients with acute myocardial infarction: A nationwide propensity matched analysis

Rupak Desai  1 , Adhvithi Pingili  2 , Arankesh Mahadevan  3 , Vishal Reddy Bejugam  4 , Hafeezuddin Ahmed  5 , Vamsikalyan Borra  6 , Adil Sarvar Mohammed  7 , Gayatri Bondi  8 , Shobana Krishnamurthy  9 , Nithya Borra  10 , Gurpreet Kaur  11 , Rajesh Sachdeva  1 , Timir Paul  12
Affiliations

Impact of metabolically healthy obesity on post percutaneous coronary intervention outcomes in patients with acute myocardial infarction: A nationwide propensity matched analysis

Rupak Desai et al. Obes Pillars. .

Abstract

Background: Obesity paradox in post-percutaneous coronary intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a known controversy. However, these studies included patients who had diabetes, hypertension, or hyperlipidemia. We studied relationship between metabolically healthy obesity (MHO-without diabetes, hypertension, or hyperlipidemia) and in-hospital post-PCI outcomes among AMI patients.

Methods: We extracted data from National Inpatient Sample 2020 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for admissions of AMI patients who underwent PCI. We then identified patients with diabetes, hypertension, and hyperlipidemia using Elixhauser comorbidity index and Clinical Classifications Software and excluded them. Then, using Elixhauser comorbidity index, we identified patients with and without obesity, defined as BMI > 30 kg/m 2 and propensity score matching was done for age and sex. Later, multivariable regression analysis was done for in-hospital post-PCI outcomes.

Results: Among 25605 metabolically healthy patients who had AMI and underwent PCI, 2825 had obesity, and 22780 didn't. After propensity score matching (PSM) for age and sex, both cohorts had 2795 patients each. There was no statistically significant difference in in-hospital all-cause mortality (adjusted odds ratio [OR] 1.14, 95 % confidence interval [CI] 0.63-2.10, p = 0.661), post-PCI stroke (aOR 1.17, 95 % CI 0.50-2.75, p = 0.714), acute kidney injury (aOR 1.20, 95 % CI 0.84-1.72, p = 0.322), post-PCI bleeding (aOR 1.04, 95 % CI 0.35 to 3.12, p = 0.940) and intra or post-PCI cardiac arrest (aOR 1.14, 95 % CI 0.30 to 4.42, p = 0.835) between both cohorts.

Conclusions: No statistically significant association was found between obesity and post-PCI outcomes in metabolically healthy patients with AMI. Larger studies are needed to explore the controversial "obesity paradox" in cardiovascular diseases.

Keywords: Body mass index; Metabolically healthy obesity; Myocardial infarction; Obesity; Percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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