Association of Body Mass Index with In-Hospital Left Ventricular Failure after Percutaneous Coronary Interventions

Abstract

Abstract:Background: Obesity is an independent cardiovascular risk factor. The most common anthropometric measurement used to quantify obesity is body mass index (BMI). Percutaneous coronary intervention (PCI) is associated with various types of complications. The relationship between BMI and in-hospital complications particularly left ventricular failure (LVF) after PCI has not been thoroughly investigated, especially in Bangladesh. Methods:This cross sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e" 23.0 kg/m2). In-hospital LVF after PCI were observed and recorded. Results:The mean BMI of study population was 23.9 ± 1.9 kg/m 2 . The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean duration of hospital stay after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse inhospital 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: BMI is inversely associated with in-hospital LVF after PCI. The underweight and normal weight people are at greater risk to experience in-hospital LVF than overweight and obese people following PCI.

A Scoping Review of The Percutaneous Coronary Intervention: Practice Transformation for the Operational Access

“…[19][20][21] PCI is a known procedure and well practices via both the traditional and alternative approaches in Bangladesh. [22][23][24][25][26] The reported procedural technique and clinical outcomes have been reflected the potential risk-benefit profile of the percutaneous coronary intervention scenario. However, a head-to-head comparative study evaluating similar parameters in our population is limited.…”

Obesity Paradox in Short-Term Clinical Outcomes After Percutaneous Coronary Interventions

“…11 Globally, 30% of all deaths can be attributed to cardiovascular disease, of which more than half are caused by CAD. 12 With the combination of sophisticated equipment, experienced operators, and modern drug therapy, coronary angioplasty has evolved into an effective nonsurgical modality for treating patients with CAD. 13 The number of PCIs is expected to grow modestly (1% to 5%) over the next decade as a result of the aging population and an increased frequency of diabetes and obesity.…”

“…14 Institute for Health Metrics and Evaluation at University of Washington reported 17% of adults of Bangladesh as overweight or obese. 12 The complex interplay between abdominal obesity and insulin resistance appears to be a prime candidate in explaining this excess cardiovascular risk of South Asian people. The recognition and adoption of ethnic-specific BMI cutoffs represent a major step forward in refining risk stratification in different ethnic groups, including South Asians.…”