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

2015; Public Library of Science; Volume: 10; Issue: 2 Linguagem: Inglês

10.1371/journal.pone.0117142

1932-6203

Simona Littnerová, Jiří Pařenica, Jindřich Špinar, Jiří Vítovec, Aleš Linhart, Petr Widimský, Jiří Jarkovský, Roman Miklík, Lenka Špinarová, K Zeman, Jan Bělohlávek, Filip Málek, Marián Felšőci, Jiří Kettner, Petr Ošťádal, C Cíhalík, Jiří Špác, Hikmet Al‐Hiti, Marián Fedorco, Richard Fojt, Andreas Krüger, Josef Málek, Tereza Mikušová, Zdeněk Monhart, Stanislava Bohacova, Lidka Pohludkova, Filip Roháč, J. Václavík, Dagmar Vondraková, Klaudia Vyskočilová, Miroslav Bambuch, Ladislav Dušek,

Nutrition and Health in Aging

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 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.