Abstract 12149: Severe Obesity, but not Overweight, is Associated With Short- and Long-term Decreased Mortality in Patients With Type 2 Diabetes Hospitalized for Acute Decompensated Heart Failure: Findings From the Gulf-care
Introduction: A U-shaped relationship has been reported between BMI and cardiovascular events among patients with acute decompensated heart failure (ADHF).
Hypothesis: We hypothesized that an obesity paradox governs the relationship between BMI and mortality in patients with type 2 diabetes (T2D) and ADHF.
Methods: The Gulf-CARE (Gulf aCute heArt failuRe rEgistry) is a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure in 7 Middle Eastern countries. We studied 3-month and 12-month mortality in patients with T2D hospitalized for ADHF according to 5 BMI categories: Underweight (<20 kg/m2), normal weight (referent group, 20-24.9 kg/m2), overweight, (25-29.9 kg/m2), obese (30-34.9 kg/m2) and severely obese (>=35 kg/m2).
Results: Among the 5005 patients admitted in the GULF-CARE registry, 2492 (49.8%) had T2D. Underweight patients had a higher 3-month and 12-month mortality risk (OR 2.04, 95% CI [1.02-4.08], p= 0.04; OR 2.44, 95% CI [1.35-4.3], p=0.003; respectively), compared to normal weight. Overweight and obese patients had a mortality risk similar to that of normal weight. However, severe obesity (BMI >=35 kg/m2) was associated with a lower 3-month and 6-month mortality risk (OR 0.53, 95% CI [0.34-0.83], p=0.005; OR 0.58, 95% CI [0.42-0.81]; p=0.01; respectively). After adjustment for several risk variables, including age, gender, hypertension, smoking, dyslipidemia, LVEF, heart rate, ADHF etiology, BP and medications at discharge, the primary outcome was still significantly increased in underweight patients at 3 months and 12 months, and decreased in severely obese patients for the same period.
Conclusions: In this cohort of patients with ADHF, a U-shape relationship between BMI and mortality was not found in patients with T2D. Protection against long-term mortality increases in obese patients, reaching a significant peak in severely obese ones.
Figure 1: 12-month mortality risk. * p= 0.004; ** p= 0.008
Author Disclosures: C. Abi Khalil: None. K. Suleiman: None. R. Singh: None. N. Asaad: None. A. Jayyousi: None. J. Al Suwaidi: None.
- © 2016 by American Heart Association, Inc.