학술논문
Positive Influence of Being Overweight/Obese on Long Term Survival in Patients Hospitalised Due to Acute Heart Failure.
Document Type
Article
Author
Littnerova, Simona; Parenica, Jiri; Spinar, Jindrich; Vitovec, Jirí; Linhart, Ales; Widimsky, Petr; Jarkovsky, Jiri; Miklik, Roman; Spinarova, Lenka; Zeman, Kamil; Belohlavek, Jan; Malek, Filip; Felsoci, Marian; Kettner, Jiri; Ostadal, Petr; Cihalik, Cestmir; Spac, Jiri; Al-Hiti, Hikmet; Fedorco, Marian; Fojt, Richard
Source
Subject
*HEART failure patients
*OVERWEIGHT persons
*MORTALITY
*BODY mass index
*BIOMARKERS
*FOLLOW-up studies (Medicine)
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Language
ISSN
1932-6203
Abstract
Background: Obesity is clearly associated with increased morbidity and mortality rates. However, in patients with acute heart failure (AHF), an increased BMI could represent a protective marker. Studies evaluating the “obesity paradox” on a large cohort with long-term follow-up are lacking. Methods: Using the AHEAD database (a Czech multi-centre database of patients hospitalised due to AHF), 5057 patients were evaluated; patients with a BMI <18.5 kg/m2 were excluded. All-cause mortality was compared between groups with a BMI of 18.5–25 kg/m2 and with BMI >25 kg/m2. Data were adjusted by a propensity score for 11 parameters. Results: In the balanced groups, the difference in 30-day mortality was not significant. The long-term mortality of patients with normal weight was higher than for those who were overweight/obese (HR, 1.36; 95% CI, 1.26–1.48; p<0.001)). In the balanced dataset, the pattern was similar (1.22; 1.09–1.39; p<0.001). A similar result was found in the balanced dataset of a subgroup of patients with de novo AHF (1.30; 1.11–1.52; p = 0.001), but only a trend in a balanced dataset of patients with acute decompensated heart failure. Conclusion: These data suggest significantly lower long-term mortality in overweight/obese patients with AHF. The results suggest that at present there is no evidence for weight reduction in overweight/obese patients with heart failure, and emphasize the importance of prevention of cardiac cachexia. [ABSTRACT FROM AUTHOR]