Obesity and inhospital prognosis in acute heart failure

Background

Previous studies have defined that obesity is a risk factor for the development of heart failure. However, whether obesity influences inhospital mortality of patients with heart failure remains unknown.

Objectives

To analyze the obesity impact, measured by the body mass index (BMI), on inhospital morbidity and mortality of the patients with heart failure, and to correlate them with other serum markers, like BNP and D-dimer.

Materials and methods

A cohort study with 125 patients with heart failure (mean age = 54 years; 55.2% male, 79.2% NYHA functional class VI) admitted to the coronary care unit between January 2003 and December 2004. This sample was divided into three groups according to their BMI (weight:height²): group A – BMI <25, group B – BMI = 25–29.9, and group C – BMI ≥ 30. The inhospital complications of incidence, mortality and admission serum D-dimer and BNP were compared. Risk factors, complications and inhospital mortality, were compared using the likelihood ratio chi-square test. The Kruskal–Wallis test was used to correlate the BMI with serum markers and ANOVA. Statistical significance was set at P ≤ 0.05.

Results

The sample was divided into three groups (group A – 56.8%, group B – 29.6% and group C – 13.6%). There was no difference in age between the two groups (P = 0.14). Diabetes was more frequent in group B (overweight). Obese patients (group C) had lower BNP levels (P = 0.01) and D-dimer (P = 0.035). There were no differences between the three groups related to complications and inhospital mortality.

Conclusions

The elevation of the BMI is not a predictor of mortality or inhospital complications among patients with heart failure. We also observed its relation with lower levels of worse prognostic markers, like BNP and D-dimer.