Influence of weight variation on long-term mortality of patients with heart failure - 02/09/23
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Cachexia is associated with poor survival in patients with HF. |
• | Weight loss predicted higher mortality in low/normal-weight patients with HF. |
• | Weight loss also predicted higher mortality in overweight patients with HF. |
• | In obese patients, significant weight loss was not associated with poorer survival. |
• | Weight loss should not be discouraged in obese patients with HF. |
Abstract |
Background |
In heart failure, weight loss predicts dismal prognosis. Weight variations have not been addressed in obese patients with heart failure.
Aim |
To study the impact of weight variation on heart failure mortality according to body mass index strata.
Methods |
Retrospective study of patients with chronic heart failure with left ventricular ejection fraction<50%. Only patients with ≥1 year of follow-up were included. Patients with missing data for body mass index at the index and 1-year appointments were excluded. Patients were classified into three groups according to weight variation: weight gain>5%; weight loss>5%; and weight stability. Follow-up was set from the 1-year appointment. Cox-regression analysis was used to assess the prognostic impact of weight variation.
Results |
We studied 589 patients: 69.8% male; mean age, 69 years. Over 1 year, 148 patients (25.1%) gained>5% weight, 97 (16.5%) lost>5% weight and the remaining 344 were weight-stable. During 49 months of median follow-up, 248 patients died. Patients who lost>5% of their weight presented a higher death risk than the others (hazard ratio 1.61, 95% confidence interval 1.18–2.19). After multivariable adjustment, the hazard ratio for death for low/normal-weight patients who lost>5% of their weight was 1.81 (95% confidence interval 1.02–3.21; P=0.04) compared with the others. Among the overweight, those who lost>5% of their weight had a hazard ratio of 2.34 (95% confidence interval 1.32–4.12). In the initially obese subgroup, weight loss>5% was not associated with prognosis (hazard ratio 1.08, 95% confidence interval 0.53–2.19).
Conclusions |
Weight loss predicted mortality in low/normal-weight and overweight patients with heart failure. However, in obese patients, significant weight loss did not predict poorer survival. Weight loss should not be discouraged in obese patients with heart failure.
Le texte complet de cet article est disponible en PDF.Keywords : Heart failure, Body mass index, Obesity paradox, Weight variation, Prognosis
Plan
| ☆ | Tweet: Weight loss is mortality associated in non-obese HF patients; in obese ones, weight loss >5% is not clearly associated with poor prognosis. Obese HF patients should be further studied concerning weight management strategies. Twitter handle: @nunnomello. |
Vol 116 - N° 8-9
P. 403-410 - août 2023 Retour au numéro
Article précédent
- Development and validation of machine learning algorithms to predict posthypertensive origin in left ventricular hypertrophy
- Maxime Beneyto, Ghada Ghyaza, Eve Cariou, Jacques Amar, Olivier Lairez
- Is “moderate” aortic stenosis still the right name? A review of the literature
- Yohann Bohbot, Augustin Coisne, Alexandre Altes, Franck Levy, Chloé Di Lena, Samy Aghezzaf, Sylvestre Maréchaux, Dan Rusinaru, Christophe Tribouilloy
Bienvenue sur EM-consulte, la référence des professionnels de santé.