Abstract 18063: Reverse Of Obesity Paradox Seen in Morbidly Obese Patients with Advanced Heart Failure
Introduction: Obese patients tend to have a better survival than patients with normal body mass index (BMI). This ‘obesity paradox’ is well described in heart failure. But the paradox may not hold true for morbidly obese patients.
Methods: We reviewed 478 consecutive patients with advanced heart failure undergoing transplant evaluation between 2007 and 2011. Patients were divided into three groups based on their BMI [[Unable to Display Character: –]] normal (20-30), obese (30-40) and morbidly obese (>40). Chi-square test was used to identify any significant difference in rates of risk factors within these groups. Survival (death or heart transplant) analysis was assessed by Kaplan-Meier curves.
Results: Mean BMI was 28.9 ± 6.2. Normal, obese and morbidly obese groups had 303, 155 and 20 patients respectively. These groups were significantly different in rate of diabetes (p=0.001) and hypertension (p=0.024), but no significant difference in rates of dyslipidemia, CAD, COPD, CVA, CKD or atrial fibrillation was observed. Mortality/transplant rates were 51%, 42% and 75% in normal, obese and morbidly obese groups. Kaplan-Meier curves shows significant separation between all three groups (log rank, p=0.001).
Conclusions: Obesity paradox is a well known entity in heart failure. But morbidly obese patients (BMI > 40) may have higher mortality than obese patients and patients with normal BMI.
- © 2012 by American Heart Association, Inc.