TY - JOUR
T1 - Anthropometric measures and long-term mortality in non-ischaemic heart failure with reduced ejection fraction
T2 - Questioning the obesity paradox
AU - Butt, Jawad H
AU - Thune, Jens Jakob
AU - Nielsen, Jens C
AU - Haarbo, Jens
AU - Videbæk, Lars
AU - Gustafsson, Finn
AU - Kristensen, Søren L
AU - Bruun, Niels E
AU - Eiskjær, Hans
AU - Brandes, Axel
AU - Hassager, Christian
AU - Svendsen, Jesper H
AU - Høfsten, Dan E
AU - Torp-Pedersen, Christian
AU - Schou, Morten
AU - Pehrson, Steen
AU - Packer, Milton
AU - McMurray, John J V
AU - Køber, Lars
N1 - © 2024 The Author(s). European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2024/8/18
Y1 - 2024/8/18
N2 - AIMS: Although body mass index (BMI) is the most commonly used anthropometric measure to assess adiposity, alternative indices such as the waist-to-height ratio may better reflect the location and amount of ectopic fat as well as the weight of the skeleton.METHODS AND RESULTS: The prognostic value of several alternative anthropometric measures was compared with that of BMI in 1116 patients with non-ischaemic heart failure with reduced ejection fraction (HFrEF) enrolled in DANISH. The association between anthropometric measures and all-cause death was adjusted for prognostic variables, including natriuretic peptides. Median follow-up was 9.5 years (25th-75th percentile, 7.9-10.9). Compared to patients with a BMI 18.5-24.9 kg/m2 (n = 363), those with a BMI ≥25 kg/m2 had a higher risk of all-cause and cardiovascular death, although this association was only statistically significant for a BMI ≥35 kg/m2 (n = 91) (all-cause death: hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.28-2.48; cardiovascular death: HR 2.46, 95% CI 1.69-3.58). Compared to a BMI 18.5-24.9 kg/m2, a BMI <18.5 kg/m2 (n = 24) was associated with a numerically, but not a significantly, higher risk of all-cause and cardiovascular death. Greater waist-to-height ratio (as an exemplar of indices not incorporating weight) was also associated with a higher risk of all-cause and cardiovascular death (HR for the highest vs. the lowest quintile: all-cause death: HR 2.11, 95% CI 1.53-2.92; cardiovascular death: HR 2.17, 95% CI 1.49-3.15).CONCLUSION: In patients with non-ischaemic HFrEF, there was a clear association between greater adiposity and higher long-term mortality.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT00542945.
AB - AIMS: Although body mass index (BMI) is the most commonly used anthropometric measure to assess adiposity, alternative indices such as the waist-to-height ratio may better reflect the location and amount of ectopic fat as well as the weight of the skeleton.METHODS AND RESULTS: The prognostic value of several alternative anthropometric measures was compared with that of BMI in 1116 patients with non-ischaemic heart failure with reduced ejection fraction (HFrEF) enrolled in DANISH. The association between anthropometric measures and all-cause death was adjusted for prognostic variables, including natriuretic peptides. Median follow-up was 9.5 years (25th-75th percentile, 7.9-10.9). Compared to patients with a BMI 18.5-24.9 kg/m2 (n = 363), those with a BMI ≥25 kg/m2 had a higher risk of all-cause and cardiovascular death, although this association was only statistically significant for a BMI ≥35 kg/m2 (n = 91) (all-cause death: hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.28-2.48; cardiovascular death: HR 2.46, 95% CI 1.69-3.58). Compared to a BMI 18.5-24.9 kg/m2, a BMI <18.5 kg/m2 (n = 24) was associated with a numerically, but not a significantly, higher risk of all-cause and cardiovascular death. Greater waist-to-height ratio (as an exemplar of indices not incorporating weight) was also associated with a higher risk of all-cause and cardiovascular death (HR for the highest vs. the lowest quintile: all-cause death: HR 2.11, 95% CI 1.53-2.92; cardiovascular death: HR 2.17, 95% CI 1.49-3.15).CONCLUSION: In patients with non-ischaemic HFrEF, there was a clear association between greater adiposity and higher long-term mortality.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT00542945.
UR - http://www.scopus.com/inward/record.url?scp=85201372403&partnerID=8YFLogxK
U2 - 10.1002/ejhf.3424
DO - 10.1002/ejhf.3424
M3 - Journal article
C2 - 39155576
SN - 1388-9842
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
ER -