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Int J Cardiol. 2019 Feb 1;276:166-170. doi: 10.1016/j.ijcard.2018.08.054. Epub 2018 Aug 18.

A reduction of BMI predicts the risk of rehospitalization and cardiac death in non-obese patients with heart failure.

Author information

1
Department of Cardiovascular Medicine, Saga University, Saga, Japan.
2
Department of Cardiovascular Medicine, Saga University, Saga, Japan. Electronic address: junoyama@cc.saga-u.ac.jp.

Abstract

BACKGROUND:

Low body mass index (BMI) has been associated with decreased survival in patients with heart failure (HF), although Obesity is an important risk factor for cardiovascular disease. HF patients with a relatively higher BMI tend to live longer, which is known as "Obesity Paradox". However, cardiac cachexia is another determinant of prognosis in HF patients. This study investigated whether a change in BMI is associated with either prognosis or frequency of hospitalizations in patients with HF.

METHODS:

We correlated changes in BMI to prognosis and frequency of hospitalizations in patients who were hospitalized for decompensated HF. A total of 971 HF patients were initially evaluated, and 81 patients with repeat HF admissions were included.

RESULTS:

The average change in BMI was -0.05 ± 0.15, -0.87 ± 0.56, -1.03 ± 0.34, and -1.97 ± 0.33 in patients who were hospitalized twice, three times, four times, and over five times, respectively. The reduction in BMI correlated with the frequency of hospitalizations (P < 0.01). We compared patients with increased BMI (group I, n = 38) versus decreased BMI (group D, n = 43) between the first and second discharge. The rate of hospitalization in group D was higher than in group I, and group D had a lower survival rate. The reduction of BMI was a significant and independent risk factor for cardiac death (HR, 4.17; 95% CI, 1.53 to 14.6).

CONCLUSIONS:

Losing body weight in HF patients was a significant predictive factor of the frequency of hospitalizations and increased mortality.

KEYWORDS:

Body mass index; Heart failure; Hospitalization

PMID:
30139701
DOI:
10.1016/j.ijcard.2018.08.054
[Indexed for MEDLINE]

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