Obesity paradox: a myth or reality, time to reveal the fact in a South Asian cohort presenting with STE-ACS undergoing primary percutaneous coronary intervention

Objectives Obesity is a globally well-established risk factor for atherosclerotic cardiovascular diseases; however, some studies have witnessed survival benefits among obese patients and this phenomenon termed ‘the obesity paradox’. Our aim was to evaluate the existence of an paradox in with ‘ST-elevation acute coronary syndrome (STE-ACS)’ our population. Methods In observational study, we included presenting STE-ACS undergoing primary percutaneous intervention (PCI). Body mass index (BMI) ‘(weight (kg)/height (m) 2 ) calculated BMI ≥30 kg/m were categorised as obese. All observed during their hospital stay postprocedure in-hospital morbidity (pump failure, contrast-induced nephropathy, major bleeding, cerebrovascular accident/stroke, access site complications or stent thrombosis) mortality. Results A total 1099 included, out which 78% (857) men, mean age 54.66±10.9 years. The 27.48±4.93 23.2% (255) rate 13.4% (113/844) vs 8.6% (22/255); p=0.042 mortality 1.9% (16/844) 4.7% (12/255); p=0.013 non-obese patients, respectively. On multivariable analysis, showed paradoxical protective effect adjusted OR 0.59 (95% CI 0.36 0.96, p=0.033) morbidity. However, found be independent predictor 3.13 1.37 7.15, p=0.007). Conclusion conclusion, evidence morbidity, but not mortality, after PCI ST-ACS