Positive Influence of Being Overweight/Obese on Long Term Survival in Patients Hospitalised Due to Acute Heart Failure

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Authors	LITTNEROVÁ Simona PAŘENICA Jiří ŠPINAR Jindřich VÍTOVEC Jiří LINHART Ales WIDIMSKÝ Petr JARKOVSKÝ Jiří MIKLÍK Roman ŠPINAROVÁ Lenka ZEMAN Kamil BELOHLAVEK Jan MALEK Filip FELŠŐCI Marián KETTNER Jiří OSTADAL Petr CIHALIK Cestmir ŠPÁC Jiří AL-HITI Hikmet FEDORCO Marian FOJT Richard KRUGER Andreas MALEK Josef MIKUŠOVÁ Tereza MONHART Zdenek BOHACOVA Stanislava POHLUDKOVA Lidka ROHAC Filip VACLAVIK Jan VONDRAKOVA Dagmar VYSKOČILOVÁ Klaudia BAMBUCH Miroslav DUŠEK Ladislav
Year of publication	2015
Type	Article in Periodical
Magazine / Source	Plos one
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1371/journal.pone.0117142
Field	Cardiovascular diseases incl. cardiosurgery
Keywords	BODY-MASS INDEX; ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; OBESITY PARADOX; RISK-FACTORS; MORTALITY; ASSOCIATION; REGISTRY; ADIPOCYTOKINE; GUIDELINES
Description	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/m(2) were excluded. All cause mortality was compared between groups with a BMI of 18.5-25 kg/m(2) and with BMI >25 kg/m(2). 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.
Related projects:	Diagnostika akutní myokarditidy mimikující akutní infarkt myokardu s ST elevacemi