PLoS ONE (Jan 2015)

Positive influence of being overweight/obese on long term survival in patients hospitalised due to acute heart failure.

  • Simona Littnerova,
  • Jiri Parenica,
  • Jindrich Spinar,
  • Jirí Vitovec,
  • Ales Linhart,
  • Petr Widimsky,
  • Jiri Jarkovsky,
  • Roman Miklik,
  • Lenka Spinarova,
  • Kamil Zeman,
  • Jan Belohlavek,
  • Filip Malek,
  • Marian Felsoci,
  • Jiri Kettner,
  • Petr Ostadal,
  • Cestmir Cihalik,
  • Jiri Spac,
  • Hikmet Al-Hiti,
  • Marian Fedorco,
  • Richard Fojt,
  • Andreas Kruger,
  • Josef Malek,
  • Tereza Mikusová,
  • Zdenek Monhart,
  • Stanislava Bohacova,
  • Lidka Pohludkova,
  • Filip Rohac,
  • Jan Vaclavik,
  • Dagmar Vondrakova,
  • Klaudia Vyskocilova,
  • Miroslav Bambuch,
  • Ladislav Dusek

DOI
https://doi.org/10.1371/journal.pone.0117142
Journal volume & issue
Vol. 10, no. 2
p. e0117142

Abstract

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BackgroundObesity 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.MethodsUsing 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.ResultsIn 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; pConclusionThese 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.