Body Composition Analysis in Young Pakistani Adults with Stable Ischemic Heart Disease versus Acute Coronary Syndrome

Muhammad Nadeem; Azhar Ali Chaudhry; Qamar-Uz-Zaman   Bhatti; Rizwan  Ali; Iqbal Haider; Tahir   Zaman

doi:10.51253/pafmj.v76iSUPPL-4.14167

Authors

Muhammad Nadeem Department of Adult Cardialogy, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Azhar Ali Chaudhry Department of Adult Cardialogy, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Qamar-Uz-Zaman Bhatti Department of Adult Cardialogy, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Rizwan Ali Department of Adult Cardialogy, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Iqbal Haider Department of Adult Cardialogy, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Tahir Zaman Department of Adult Cardialogy, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-4.14167

Keywords:

Acute Coronary Syndrome, Body Composition, Stable Ischemic Heart Disease

Abstract

Objective: To analyze the mean difference in total body composition on Bioelectrical Impedance Analyzer (fat percentage, lean body mass, visceral fat area, and segmental fat/muscle distribution) between young adults with SIHD and ACS.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Aug to Nov 2025.

Methodology: Two hundred patients (males aged 18–45 years and females aged 18–50 years) were enrolled using non-probability convenience sampling. Patients with acute illness, inflammatory conditions, or uncontrolled endocrine disorders affecting body composition were excluded. Participants were categorized into ACS-Group and SIHD-Group. Body composition was assessed using the InBody 270 analyzer in the upright position, with measurements performed in the morning after an overnight fast.

Results: Among the 200 study participants, the ACS-Group (n=100) had a slightly higher median age [38.0 (32.0–44.0) years] than the SIHD-Group [34.0 (29.5–42.0) years, p-value =0.05]. However, ACS patients demonstrated a higher heart rate (92.08±14.61 vs. 78.96±12.46 bpm), greater skeletal muscle mass [38.08 (36.43–39.92) vs. 29.52 (28.04–31.12) kg], higher lean body mass [57.77 (56.21–59.66) vs. 49.29 (47.71–51.59) kg], and an elevated waist-to-hip ratio (0.93±0.09 vs. 0.902±0.09) compared with the SIHD-Group.

Conclusion: Body composition parameters and lipid abnormalities contribute to early-onset coronary artery disease, with distinct patterns in ACS and SIHD. Incorporating body composition assessment into conventional risk evaluation may enhance risk stratification and support targeted prevention in high-risk young individuals.

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References

1. Yang L, Zheng B, Gong Y. Global, regional and national burden of ischemic heart disease and its attributable risk factors from 1990 to 2021: a systematic analysis of the Global Burden of Disease study 2021. BMC Cardiovasc Disord 2025; 25: 625.

https://doi.org/10.1186/s12872-025-05022-x

2. Jafar TH, Jafary FH, Jessani S, Chaturvedi N. Heart disease epidemic in Pakistan: women and men at equal risk. Am Heart J 2005; 150(2): 221-226.

https://doi.org/10.1016/j.ahj.2004.09.025

3. Samad Z, Hanif B. Cardiovascular diseases in Pakistan: imagining a postpandemic, postconflict future. Circulation 2023; 147(17): 1261-1263.

https://doi.org/10.1161/CIRCULATIONAHA.122.059122

4. Khan SS, Jan R. Pattern of Coronary Artery Disease in Patients Presenting with Acute Coronary Syndrome at Peshawar Institute of Cardiology. Indus Journal of Bioscience Research 2025; 3(3): 1-5. https://doi.org/10.70749/ijbr.v3i3.709

5. Sher A, Bashir MA, Humerah S, Khan MR, Raja NS, Hussain I. Prevalence of acute coronary syndrome among patients presenting with chest pain. Pakistan Journal of Medical & Health Sciences 2022; 16(10): 932.

https://doi.org/10.53350/pjmhs221610932

6. Thamer C, Stefan N, Fritsche A, Häring HU. High Baseline Vitamin C Levels Do Not Prevent a Positive Outcome of a Lifestyle Intervention: Response to Blüher et al. Diabetes Care 2010; 33(1): e18.

https://doi.org/10.2337/dc09-1870

7. McLester CN, Nickerson BS, Kliszczewicz BM, McLester JR. Reliability and agreement of various InBody body composition analyzers as compared to dual-energy X-ray absorptiometry in healthy men and women. Journal of Clinical Densitometry 2020; 23(3): 443-540.

https://doi.org/10.1016/j.jocd.2018.10.008

8. Peerwani G, Hanif B, Rahim KA, Kashif M, Virani SS, et al Presentation, management, and early outcomes of young acute coronary syndrome patients-analysis of 23,560 South Asian patients from 2012 to 2021. BMC Cardiovascular Disorders 2024; 24(1): 378.

https://doi.org/10.1186/s12872-024-04036-1

9. Kim SR, Lee G, Choi S, Oh YH, Son JS, Park M, et al. Changes in predicted lean body mass, appendicular skeletal muscle mass, and body fat mass and cardiovascular disease. J Cachexia Sarcopenia Muscle 2022; 13(2): 1113–1123.

http:// doi.org/10.1002/jcsm.12962

10. Xie FY, Zhu QK, Tu YH, Wei L, Wang XD, Gu YW, et al. Serum nutritional indexes and body composition parameters evaluated by body impedance analysis: differences between patients with acute myocardial infarction and stable coronary artery disease. International Journal Of Clinical And Experimental Medicine 2016; 9(10): 19981-7.

www.ijcem.com /ISSN:1940-5901/IJCEM0031112

11. Cesaro A, De Michele G, Fimiani F, Acerbo V, Scherillo G, Signore G, et al. Visceral adipose tissue and residual cardiovascular risk: a pathological link and new therapeutic options. Frontiers in cardiovascular medicine 2023; 10: 1187735.

http:// doi.org/10.3389/fcvm.2023.1187735

12. Karlsberg D, Steyer H, Fisher R, Crabtree T, Min JK, Earls JP, et al. Impact of visceral fat on coronary artery disease as defined by quantitative computed tomography angiography. Obesity. 2023; 31(10): 2460-2466.

http:// doi.org/10.1002/oby.23804

13. Antonio-Villa NE, Juárez-Rojas JG, Posadas-Sánchez R, Reyes-Barrera J, Medina-Urrutia A. Visceral adipose tissue is an independent predictor and mediator of the progression of coronary. a prospective sub-analysis of the GEA study. Cardiovasc Diabetol 22: 81: 2023.

https://doi.org/10.1186/s12933-023-01807-6

14. Taha H, Alshehri M, El-Hosary H, Elagha A, Mahrous H, Shaker M, et al. Disparities in patterns and outcomes of dyslipidemic patients with acute coronary syndrome: A tertiary cardiac center registry. Atherosclerosis Plus 2025; 59: 18-24.

https://doi.org/10.1016/j.athplu.2024.11.004

15. Yang J, Zhang R, Han B, Li H, Wang J, Xiao Y, et al. Atherogenic lipid profile in patients with statin treatment after acute coronary syndrome: a real-world analysis from Chinese cardiovascular association database. Lipids in Health and Disease 2024; 23(1): 271.

https://doi.org/10.1186/s12944-024-02244-4

16. Pogran E, Burger AL, Zweiker D, Kaufmann CC, Muthspiel M, Rega-Kaun G, et al Lipid-lowering therapy after acute coronary syndrome. Journal of Clinical Medicine 2024; 13(7): 2043.

https://doi.org/10.3390/jcm13072043

17. Emamat H, Jamshidi A, Farhadi A, Ghalandari H, Ghasemi M, Tangestani H. The association between the visceral to subcutaneous abdominal fat ratio and the risk of cardiovascular diseases: a systematic review. BMC Public Health 2024; 24(1): 1827. https://doi.org/10.1186/s12889-024-19358-0

18. Wan H, Wu H, Wei Y, Wang S, Ji Y. Novel lipid profiles and atherosclerotic cardiovascular disease risk: insights from a latent profile analysis. Lipids in Health and Disease. 2025 Feb 25;24(1):71.calcification: a prospective sub-analysis of the GEA study. Cardiovascular Diabetology 2023; 22(1): 81.

https://doi.org/10.1186/s12944-025-02471-3

19. Moniruzzaman M, Koli A, Malik F, Islam S. Association between body mass index (BMI) and severity of coronary artery disease in young onset acute coronary syndrome (ACS). European Heart Journal 2023; 44(Supplement_1): ehac779-058.

http://doi.org/10.18535/ijmsci/v7i10.01