Abstract 1551: Obesity Increases the Risk for Hospitalization and Death Only in Patients With Heart Failure Who Have Diabetes as a Comorbidity
Background: Diabetes mellitus (DM) is associated with increased risk of death and cardiac related hospitalization in patients with HF. DM is also associated with obesity, which has paradoxically been associated with better event-free survival in patients with HF. The combined effect of obesity and DM on HF outcomes has not been described.
Purpose: To compare event-free survival (all cause hospitalization and death) of obese HF patients with and without DM to normal weight patients without DM.
Methods: A total of 265 patients (age 60± 12, 38% female, 49% NYHA III/IV, 38% DM) recruited from HF clinics were followed for hospitalization and death. Weight and height were measured using professional grade scales and stadiometers. The diagnosis of DM was confirmed by medical record review. Patients were stratified into 3 groups: normal weight (18.5–24.9 kg/m2) without DM and obese (≥30 kg/m2) with and without DM. Normal weight patients with DM were not included due to insufficient sample size. Cox regression was used to compare differences in event-free survival among groups.
Results: Thirty-eight percent of patients experienced an event. There was no significant difference in event-free survival between obese patients without DM and normal weight patients without DM controlling for age, gender, NYHA class, LVEF, and depressive symptoms (p=.4). In contrast, obese patients with DM had double the risk for all cause hospitalization and death compared to the normal weight group (HR=2.04, 95% CI=1.15–3.6, p=.016; Figure⇓).
Conclusion: These data show that obese patients with HF who do not have DM have a similar risk for hospitalization and death as normal-weight patients without DM.
This research has received full or partial funding support from the American Heart Association, Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania & West Virginia).