Relation between Body Mass Index and Clinical Outcome after Percutaneous Coronary Intervention of Chronic Total Occlusion

Farid, Walaa; Fawzy, Ahmed; Elkersh, Ahmed

doi:10.21608/ejhm.2025.414138.1820

Relation between Body Mass Index and Clinical Outcome after Percutaneous Coronary Intervention of Chronic Total Occlusion

Document Type : Original Article

Authors

¹ Cardiology department, Faculty of Medicine, Menoufia University, Egypt

² Cardiology Faculty of Medicine, Menoufia University

10.21608/ejhm.2025.414138.1820

Abstract

Background: Obesity is a significant risk factor for coronary artery disease (CAD), which continues to be a primary cause of death. About 20% of individuals undergoing coronary angiography have chronic complete occlusion (CTO), and although PCI is the recommended course of treatment, the results in obese people are still not fully understood.
Aim of the study: to evaluate the relationship between clinical outcomes following PCI for chronic complete blockage and BMI.
Patients and Methods: A cross-sectional retrospective cohort study included 40 adults who received PCI for angiographically confirmed chronic total occlusion in two Egyptian tertiary centers and examined the association of BMI with post-procedureoutcomes. The patients were followed up for 3 months with procedural success, MACE, and symptom relief as endpointmeasurements. Results: Out of 40 PCI patients, baseline, angiographic, and procedural factors within BMI groups were largely similar, with differences significant only in prior PCI (p=0.040) and baseline ECG abnormality (p=0.016). Adverse effects were rare, with no difference in procedural success among BMI groups. Lesion complexity, as indicated by higher J-CTO scores, was the main factor for longer wire crossing time and greater contrast usage, and not BMI.
Conclusion: BMI did not differentially affect procedural success, complications, or post-discharge outcomes with CTO-PCI, even though higher J-CTO scores and chest pain were more frequent in overweight/obese patients, implying potential correlation withlesion complexity or symptom burden. This is in line with the "obesity paradox" where overweight patients have comparable or better outcomes than normal-weight patients.

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