A reduction of BMI predicts the risk of rehospitalization and cardiac death in non-obese patients with heart failure. (1st February 2019)

• Record Type: Journal Article
• Authors: Nishikido, Toshiyuki; Oyama, Jun-ichi; Nagatomo, Daisuke; Node, Koichi
• Is Part Of: International journal of cardiology. Volume 276(2019)
• Page Start: 166
• Page End: 170
• Publication Date: 2019-02-01
• Subjects: BMI body mass index -- HF heart failure -- eGFR estimated glomerular filtration rate -- CONUT Controlling Nutritional Status -- TNF-α tumor necrosis factor (TNF)-α; Body mass index -- Heart failure -- Hospitalization; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.08.054
• Languages: English
• ISSNs: 0167-5273

Abstract

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.