Body Mass Index and Mortality in Acutely Decompensated Heart
Failure Across the World

J 2014

Body Mass Index and Mortality in Acutely Decompensated Heart Failure Across the World

SHAH, Ravi; Etienne GAYAT; James L. JANUZZI; Naoki SATO; Alain COHEN-SOLAL et al.

Základní údaje

Originální název

Body Mass Index and Mortality in Acutely Decompensated Heart Failure Across the World

Autoři

Vydání

Journal of The American College of Cardiology, NEW YORK, Elsevier Science, 2014, 0735-1097

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 16.503

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/14:00074969

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

heart failure; obesity; obesity paradox

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 15. 4. 2014 12:00, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Objective To define the relationship between body mass index (BMI) and mortality in heart failure (HF) across the world and identify specific groups in whom BMI may differentially mediate risk. Background Obesity is associated with incident heart failure (HF), but is paradoxically associated with better prognosis during chronic HF. Methods We studied 6,142 patients with acute decompensated HF from 12 prospective observational cohorts followed across 4 continents. Primary outcome was all-cause mortality. Cox proportional hazards models and net reclassification index (NRI) described associations of BMI with all-cause mortality. Results “Normal” weight patients (BMI 18.5-25 kg/m2) were older with more advanced HF and lower cardiometabolic risk. Despite worldwide heterogeneity in clinical features across obesity categories, a higher BMI remained associated with decreased 30-day and 1-year mortality (11% decrease at 30 days; 9% decrease at 1 year per 5 kg/m2; P<0.05), after adjustment for clinical risk. BMI obtained at index admission provided effective 1-year risk reclassification beyond current markers of clinical risk (NRI 0.119, P <.001). Notably, the “protective” association of BMI with mortality was confined to those with older age (>75; HR=0.82, P=0.006), decreased cardiac function (ejection fraction < 50%; HR=0.85, P<.001), non-diabetics (HR=0.86, P<.001), and de novo HF (HR=0.89, P=0.004). Conclusions A lower BMI is associated with age, disease severity, and a higher risk of death in ADHF. The “obesity paradox” is confined to older individuals, decreased cardiac function, less cardiometabolic illness, and recent onset HF, suggesting that aging, HF severity/chronicity, and metabolism may explain the obesity paradox.

Citovat

SHAH, Ravi; Etienne GAYAT; James L. JANUZZI; Naoki SATO; Alain COHEN-SOLAL; Salvatore DISOMMA; Enrique FAIRMAN; Veli-Pekka HARJOLA; Shiro ISHIHARA; Johan LASSUS; Aldo MAGGIONI; Marco METRA; Christian MUELLER; Thomas MUELLER; Jiří PAŘENICA; Domingo PASCUAL-FIGAL; Frank PEACOCK; Jindřich ŠPINAR; Roland van KIMMENADE a Alexandre MEBAZAA. Body Mass Index and Mortality in Acutely Decompensated Heart Failure Across the World. Journal of The American College of Cardiology. NEW YORK: Elsevier Science, 2014, roč. 63, č. 8, s. 778-785. ISSN 0735-1097. Dostupné z: https://doi.org/10.1016/j.jacc.2013.09.072.

@article{1161550,
   author = {Shah, Ravi and Gayat, Etienne and Januzzi, James L. and Sato, Naoki and CohenandSolal, Alain and diSomma, Salvatore and Fairman, Enrique and Harjola, VeliandPekka and Ishihara, Shiro and Lassus, Johan and Maggioni, Aldo and Metra, Marco and Mueller, Christian and Mueller, Thomas and Pařenica, Jiří and PascualandFigal, Domingo and Peacock, Frank and Špinar, Jindřich and Kimmenade, Roland van and Mebazaa, Alexandre},
   article_location = {NEW YORK},
   article_number = {8},
   doi = {https://doi.org/10.1016/j.jacc.2013.09.072},
   keywords = {heart failure; obesity; obesity paradox},
   language = {eng},
   issn = {0735-1097},
   journal = {Journal of The American College of Cardiology},
   title = {Body Mass Index and Mortality in Acutely Decompensated Heart Failure Across the World},
   volume = {63},
   year = {2014}
}

TY  - JOUR
ID  - 1161550
AU  - Shah, Ravi - Gayat, Etienne - Januzzi, James L. - Sato, Naoki - Cohen-Solal, Alain - diSomma, Salvatore - Fairman, Enrique - Harjola, Veli-Pekka - Ishihara, Shiro - Lassus, Johan - Maggioni, Aldo - Metra, Marco - Mueller, Christian - Mueller, Thomas - Pařenica, Jiří - Pascual-Figal, Domingo - Peacock, Frank - Špinar, Jindřich - Kimmenade, Roland van - Mebazaa, Alexandre
PY  - 2014
TI  - Body Mass Index and Mortality in Acutely Decompensated Heart Failure Across the World
JF  - Journal of The American College of Cardiology
VL  - 63
IS  - 8
SP  - 778-785
EP  - 778-785
PB  - Elsevier Science
SN  - 07351097
KW  - heart failure
KW  - obesity
KW  - obesity paradox
N2  - Objective To define the relationship between body mass index (BMI) and mortality in heart failure (HF) across the world and identify specific groups in whom BMI may differentially mediate risk. Background Obesity is associated with incident heart failure (HF), but is paradoxically associated with better prognosis during chronic HF. Methods We studied 6,142 patients with acute decompensated HF from 12 prospective observational cohorts followed across 4 continents. Primary outcome was all-cause mortality. Cox proportional hazards models and net reclassification index (NRI) described associations of BMI with all-cause mortality. Results “Normal” weight patients (BMI 18.5-25 kg/m2) were older with more advanced HF and lower cardiometabolic risk. Despite worldwide heterogeneity in clinical features across obesity categories, a higher BMI remained associated with decreased 30-day and 1-year mortality (11% decrease at 30 days; 9% decrease at 1 year per 5 kg/m2; P<0.05), after adjustment for clinical risk. BMI obtained at index admission provided effective 1-year risk reclassification beyond current markers of clinical risk (NRI 0.119, P <.001). Notably, the “protective” association of BMI with mortality was confined to those with older age (>75; HR=0.82, P=0.006), decreased cardiac function (ejection fraction < 50%; HR=0.85, P<.001), non-diabetics (HR=0.86, P<.001), and de novo HF (HR=0.89, P=0.004). Conclusions A lower BMI is associated with age, disease severity, and a higher risk of death in ADHF. The “obesity paradox” is confined to older individuals, decreased cardiac function, less cardiometabolic illness, and recent onset HF, suggesting that aging, HF severity/chronicity, and metabolism may explain the obesity paradox.
ER  -

SHAH, Ravi; Etienne GAYAT; James L. JANUZZI; Naoki SATO; Alain COHEN-SOLAL; Salvatore DISOMMA; Enrique FAIRMAN; Veli-Pekka HARJOLA; Shiro ISHIHARA; Johan LASSUS; Aldo MAGGIONI; Marco METRA; Christian MUELLER; Thomas MUELLER; Jiří PAŘENICA; Domingo PASCUAL-FIGAL; Frank PEACOCK; Jindřich ŠPINAR; Roland van KIMMENADE a Alexandre MEBAZAA. Body Mass Index and Mortality in Acutely Decompensated Heart Failure Across the World. \textit{Journal of The American College of Cardiology}. NEW YORK: Elsevier Science, 2014, roč.~63, č.~8, s.~778-785. ISSN~0735-1097. Dostupné z: https://doi.org/10.1016/j.jacc.2013.09.072.

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