Impact of General and Central Obesity on In-Hospital Outcomes in STE-ACS Patients Undergoing Primary PCI

Abstract

Objectives: This study aimed to investigate the distribution of general and central obesity and their combined impact on in-hospital clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation acute coronary syndrome (STE-ACS). Methodology: A consecutive sample of 1,099 STE-ACS patients undergoing primary PCI was analyzed. General obesity was defined by a body mass index (BMI) ≥ 25 kg/m², while central obesity was defined as a waist circumference of ≥ 90 cm for men and ≥ 80 cm for women. Patients were categorized into four groups: non-obese/non-centrally obese (G1), obese/non-centrally obese (G2), non-obese/centrally obese (G3), and both obese/centrally obese (G4). In-hospital morbidity and mortality were recorded and analyzed. Results: The mean age of the cohort was 54.66 ± 10.9 years, with 78% being male. The distribution of patients across the groups was as follows: G1 (19.3%), G2 (18.7%), G3 (12%), and G4 (50%). Obesity patterns significantly differed by sex (p<0.001). The incidence of heart failure varied among groups (p=0.004): G1 (10.8%), G2 (8.7%), G3 (4.5%), and G4 (4.4%). However, mortality rates did not show a statistically significant difference (p=0.212): G1 (2.4%), G2 (1%), G3 (1.5%), and G4 (3.5%). Conclusion: While no statistically significant association was observed between obesity types and clinical outcomes in STE-ACS patients undergoing PCI, a higher heart failure rate was noted among non-obese/non-centrally obese patients. These findings emphasize the need to consider both general and central obesity in cardiovascular risk assessment, particularly accounting for sex-specific differences in fat distribution.