A-39 | Impact of Obesity on In-Hospital Post Percutaneous Coronary Intervention Outcomes in Otherwise Metabolically Healthy Patients With Acute Myocardial Infarction: A Propensity Matched Analysis Using National Inpatient Sample, 2020

Abstract

Obesity paradox in post percutaneous intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a well-known controversial finding. In studies that discussed the obesity paradox, patients at least had diabetes, hypertension, or hyperlipidemia. We studied the relationship between obesity and in-hospital post-PCI outcomes among AMI patients with no diabetes, hypertension, or hyperlipidemia (otherwise metabolically healthy). We extracted data from the National Inpatient Sample 2020 using the ICD-10 codes for admissions of obese and non-obese AMI patients treated with PCI. We excluded patients with diabetes, hypertension, and hyperlipidemia after identifying them through Elixhauser comorbidity software. After propensity score matching (PSM) obese and non-obese patients for age and sex, we performed multivariate regression analysis, adjusted for demographics, hospital-level factors, and comorbidities to calculate adjusted odds ratio (AOR) for in-hospital post-PCI outcomes. In 2020, 25605 otherwise metabolically healthy AMI patients had PCI; 2825 were obese, and 22780 were non-obese. However, after PSM for age and sex, there were 2795 patients in each cohort. In the obese cohort, 68.2% were males, 82.6% were white, and 54.9% were aged 45-64. Most common comorbidities in obese vs. non-obese cohorts were smoking (23.8% vs. 24.7%), chronic pulmonary disease (14.3% vs. 11.6%), and prior MI (6.3% vs. 6.1%). A statistically significant difference was not observed in in-hospital all-cause mortality (AOR 1.14, 95%CI 0.63-2.10, p=0.661), post-operative stroke (AOR 1.17, 95%CI 0.50-2.75, p=0.714), and acute kidney injury (AOR 1.20, 95%CI 0.84-1.72, p=0.322) among obese and non-obese cohorts. In this large population-based analysis, we found no statistically significant association between obesity and post-PCI outcomes in otherwise metabolically healthy patients with AMI. Larger prospective studies can help demystify the controversial "obesity paradox" in cardiovascular diseases.