Obesity Paradox in Heart Failure with Mildly Reduced Ejection Fraction.
Pragmat Obs Res
; 15: 31-43, 2024.
Article
in En
| MEDLINE
| ID: mdl-38481568
ABSTRACT
Objective:
The study investigates the prognostic impact of body mass index (BMI) in patients hospitalized with heart failure with mildly reduced ejection fraction (HFmrEF).Background:
Limited data regarding the prognostic impact of BMI in patients with HFmrEF is available.Methods:
Consecutive patients with HFmrEF (ie, left ventricular ejection fraction 41-49% and signs and/or symptoms of HF) were retrospectively included at one institution from 2016 to 2022. Risk stratification was performed according to WHO-defined BMI groups. The primary endpoint was all-cause mortality at 30 months (median follow-up). Kaplan-Meier, uni- and multivariable Cox proportional regression analyses were applied for statistics.Results:
1832 consecutive patients with HFmrEF were included with a median BMI of 26.7 kg/m2 (IQR 24.0-30.8 kg/m2). Patients with lowest BMI (ie, 18.5-24.9 kg/m2) were associated with highest risk of all-cause mortality at 30 months compared to patients with higher BMI values (40.0% vs 29.0% vs 21.4% vs 20.9%; log rank p = 0.001; HR = 0.721; 95% CI 0.656-0.793; p = 0.001). Even after multivariable adjustment, higher BMI values were associated with improved survival at 30 months (HR = 0.963; 95% CI 0.943-0.985; p = 0.001). In contrast, the risk of HF- related rehospitalization at 30 months was not affected by BMI (log rank p = 0.064).Conclusion:
In patients hospitalized with HFmrEF, lower BMI was associated with increased risk of all-cause mortality at 30 months, suggesting an obesity paradox in HFmrEF.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Pragmat Obs Res
Year:
2024
Document type:
Article
Affiliation country:
Germany