TY - JOUR
T1 - Body mass index, treatment practices, and mortality in patients with acute heart failure
AU - Fitzgibbons, Timothy P.
AU - Hardy, Olga T.
AU - Lessard, Darleen
AU - Gore, Joel M.
AU - Yarzebski, Jorge
AU - Goldberg, Robert J.
PY - 2009/12
Y1 - 2009/12
N2 - Objectives: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. Methods: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n=216), normal weight (n=1465), overweight (n=1007), or obese (n=1034) at the time of hospitalization. Results: Obese patients with decompensated HF were significantly younger (mean age=71 years) compared with patients of normal weight (mean age=79 years). Obese patients were more likely to have a history of diabetes and have previously undergone a percutaneous coronary intervention than patients of normal body weight. Lean patients (body mass index<18.5kg/m) were less likely to be treated with effective cardiac therapies than normal weight patients, whereas obese patients were more likely to be treated with diuretics. Obese patients experienced a significantly lower in-hospital (4.3 vs. 7.2%) and 30-day (7.3 vs. 14.5%) death rate than normal weight patients, whereas lean patients experienced the highest in-hospital (10.2%) and 30-day (19.9%) death rates. Conclusion: The Results of this study in residents of a large central New England metropolitan area suggest that obesity is associated with increased survival in patients with acute HF. Further assessment of the 'obesity paradox', and careful attention to patients with a low body mass index, in patients with decompensated HF is warranted.
AB - Objectives: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. Methods: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n=216), normal weight (n=1465), overweight (n=1007), or obese (n=1034) at the time of hospitalization. Results: Obese patients with decompensated HF were significantly younger (mean age=71 years) compared with patients of normal weight (mean age=79 years). Obese patients were more likely to have a history of diabetes and have previously undergone a percutaneous coronary intervention than patients of normal body weight. Lean patients (body mass index<18.5kg/m) were less likely to be treated with effective cardiac therapies than normal weight patients, whereas obese patients were more likely to be treated with diuretics. Obese patients experienced a significantly lower in-hospital (4.3 vs. 7.2%) and 30-day (7.3 vs. 14.5%) death rate than normal weight patients, whereas lean patients experienced the highest in-hospital (10.2%) and 30-day (19.9%) death rates. Conclusion: The Results of this study in residents of a large central New England metropolitan area suggest that obesity is associated with increased survival in patients with acute HF. Further assessment of the 'obesity paradox', and careful attention to patients with a low body mass index, in patients with decompensated HF is warranted.
KW - Body mass index
KW - Heart failure
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=74249099909&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=74249099909&partnerID=8YFLogxK
U2 - 10.1097/MCA.0b013e3283324920
DO - 10.1097/MCA.0b013e3283324920
M3 - Article
C2 - 19884822
AN - SCOPUS:74249099909
SN - 0954-6928
VL - 20
SP - 536
EP - 543
JO - Coronary artery disease
JF - Coronary artery disease
IS - 8
ER -