PURPOSE: Heart failure (HF) patients often have comorbid conditions that confound management and adversely affect prognosis. The purpose of this study was to determine whether the obesity paradox is also present in hospitalized HF patients in an integrated healthcare system. DATA SOURCES: A cohort of 2707 patients with a primary diagnosis of HF was identified within an integrated, 20-hospital healthcare system. Patients were identified by ICD-9 codes or a left ventricular ejection fraction < or =40% dating back to 1995. Body mass index (BMI) was calculated using the first measured height and weight when hospitalized with HF. Survival rates were calculated using Kaplan Meier estimation. Hazard ratios for 3-year mortality with 95% confidence intervals were assessed using Cox regression, controlling for age, gender, and severity of illness at time of diagnosis. CONCLUSIONS: Three-year survival rates paradoxically improved for patients with increasing BMI. Survival rates for the larger three BMI quartiles were significantly better than for the lowest quartile after adjusting for severity of illness, age, and gender. IMPLICATIONS FOR PRACTICE: While obesity increases the risk of developing HF approximately twofold, reports involving stable outpatients suggest that obesity is associated with improved survival after the development of HF. This finding is paradoxical because obesity increases the risk and worsens the prognosis of other cardiovascular diseases.
PURPOSE:Heart failure (HF) patients often have comorbid conditions that confound management and adversely affect prognosis. The purpose of this study was to determine whether the obesity paradox is also present in hospitalized HF patients in an integrated healthcare system. DATA SOURCES: A cohort of 2707 patients with a primary diagnosis of HF was identified within an integrated, 20-hospital healthcare system. Patients were identified by ICD-9 codes or a left ventricular ejection fraction < or =40% dating back to 1995. Body mass index (BMI) was calculated using the first measured height and weight when hospitalized with HF. Survival rates were calculated using Kaplan Meier estimation. Hazard ratios for 3-year mortality with 95% confidence intervals were assessed using Cox regression, controlling for age, gender, and severity of illness at time of diagnosis. CONCLUSIONS: Three-year survival rates paradoxically improved for patients with increasing BMI. Survival rates for the larger three BMI quartiles were significantly better than for the lowest quartile after adjusting for severity of illness, age, and gender. IMPLICATIONS FOR PRACTICE: While obesity increases the risk of developing HF approximately twofold, reports involving stable outpatients suggest that obesity is associated with improved survival after the development of HF. This finding is paradoxical because obesity increases the risk and worsens the prognosis of other cardiovascular diseases.
Authors: Marjan Motie; Lorraine S Evangelista; Tamara Horwich; Michele Hamilton; Dawn Lombardo; Dan M Cooper; Pietro R Galassetti; Gregg C Fonarow Journal: Contemp Clin Trials Date: 2013-08-17 Impact factor: 2.226
Authors: Eun Kyeung Song; Debra K Moser; Susan K Frazier; Seongkum Heo; Misook L Chung; Terry A Lennie Journal: J Card Fail Date: 2010-03-19 Impact factor: 5.712
Authors: Sonia Eiras; Alfonso Varela-Román; Mariléia Cháves Andrade; Ana Castro; Rocío González-Ferreiro; Juan E Viñuela; Ángel Fernández-Trasancos; Marcos C Carreira; Ezequiel Álvarez; Felipe F Casanueva; José R González-Juanatey Journal: J Cardiovasc Transl Res Date: 2016-12-29 Impact factor: 4.132
Authors: Ross Arena; Jonathan Myers; Joshua Abella; Sherry Pinkstaff; Peter Brubaker; Brian Moore; Dalane Kitzman; Mary Ann Peberdy; Daniel Bensimhon; Paul Chase; Daniel Forman; Erin West; Marco Guazzi Journal: Am J Cardiol Date: 2009-08-28 Impact factor: 2.778