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Abstract

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. The extent of CAD and body mass index (BMI) are both considered important factors influencing cardiac performance; however, their independent association with left ventricular ejection fraction (LVEF) remains uncertain, particularly in South Asian populations.
Aim and Objective: This study aimed to evaluate the association between body mass index (BMI) and the extent of coronary artery disease (CAD) with left ventricular ejection fraction (LVEF) in patients undergoing coronary angiography at the Cardiac Center, Bahawalpur.
Methodology: A cross-sectional analytical study was conducted on 179 patients with angiographically confirmed CAD. Demographic and clinical variables, including hypertension, diabetes mellitus, and smoking status, were recorded. BMI was categorized as normal (<25 kg/m²), overweight (25–30 kg/m²), and obese (>30 kg/m²). The extent of CAD was classified as single-vessel (SVD), double-vessel (DVD), or triple-vessel disease (TVD). LVEF was measured by echocardiography. Data were analyzed using SPSS version 26. One-way ANOVA compared mean LVEF among CAD groups, and Pearson’s correlation assessed the relationship between BMI and LVEF.
Results: A statistically significant difference in mean LVEF was observed across CAD groups (F = 10.25, p < 0.001). Post hoc analysis revealed significantly lower LVEF in TVD compared to SVD and DVD groups. However, BMI showed a weak, non-significant negative correlation with LVEF (r = –0.101, p = 0.179).
Conclusion: The severity of coronary artery disease was significantly associated with reduced left ventricular systolic function, whereas BMI showed no independent correlation with LVEF. CAD burden, rather than obesity, emerged as the primary determinant of systolic dysfunction in this cohort.