Abstract 10093: Obesity Paradox is No Longer Recognized in Chronic Heart Failure Patients With Metabolic Syndrome
Background: Recently, as the developed countries are satiated with food, being overweight or obese is thought to be a risk factor for cardiovascular diseases. Even so, a number of studies reported that obesity subjects often live longer than lean peers, so-called obesity paradox. Given the uncertain role of obesity in the clinical management of some clinical settings, we examined the impact of obesity on outcomes of chronic heart failure (CHF) patients with and without metabolic syndrome (Mets).
Methods and Results: Consecutive 374 patients (mean 68 ± 12 years) were enrolled. Patients were divided into 3 groups (lower T1, middle T2, and higher T3) according to the tertile of body mass index (BMI). After the discharge, patients were followed 2 years. Endpoints were cardiac death and readmission due to worsening heart failure. There were 126 cardiac events (34%) including 32 cardiac deaths and 94 readmissions during the follow-up period. Fifty-two patients (14%) with Mets were younger and showed higher BMI compared with those without Mets. Kaplan-Meier analysis revealed that cardiac event rate was significantly lower in T3 than other 2 groups in all patients and patients without Mets (log-rank test p<0.001, each). Meanwhile, there was no association between BMI and cardiac events in patients with Mets. Cox hazard analysis showed that T3 was independently associated with cardiac events in all patients and patients without Mets after adjustment of age, gender, NYHA functional class and serum BNP level (hazard ratio 0.5, 95% CI 0.3-0.8, hazard ratio 0.4, 95% CI 0.3-0.8, respectively). However, BMI was not independently associated with cardiac events in patients with Mets.
Conclusion: Advantage of obesity was not recognized in CHF patients with Mets. Our results provide an important insight into obesity paradox in CHF patients.
- © 2013 by American Heart Association, Inc.