Is There a Gender Difference of Obesity Paradox in Systolic Heart Failure? Gender Difference of Obesity Paradox

Abstract

PurposeThe aim of the present study was to investigate the prognostic value of the obesity in patients hospitalized with acute heart failure syndrome.MethodThe Korean acute heart failure registry (KorAHF) is an on-going prospective multicenter cohort study for acute HF. As of November 2013, interim analysis of 4184 patients was performed. We categorized the study population into 4 groups by BMI value (kg/m2); BMI<18.5, 18.5≤BMI<25, 25≤BMI<30 and 30≤BMI. Study endpoint included all cause death and rehospitalization.ResultsOf total 3618 patients, 549 (28.3%) and 489 (29.1%) reached study endpoints in men and women, respectively. After adjusting, the male patients with BMI≥30 showed the lowest risk (Hazard ratio [HR]: 0.472, 95% CI: 0.267-0.836, p=0.010) compared to those with BMI<18.5. This correlation between BMI and study endpoint was not remarkable in women. In male, patients with HF with reduced ejection fraction (EF<40%), patients with BMI≥30 showed the lowest risk (HR: 0.323, 95% CI: 0.138-0.755, p=0.009) for study endpoint compared to those with BMI<18.5. However this correlation was not noted in patients with preserved ejection fraction in male.ConclusionsIn KorAHF registry, there was a gender difference of obesity paradox in patients with AHF. BMI was the independent risk factor for adverse cardiac events in men who have HF with reduced ejection fraction. PurposeThe aim of the present study was to investigate the prognostic value of the obesity in patients hospitalized with acute heart failure syndrome. The aim of the present study was to investigate the prognostic value of the obesity in patients hospitalized with acute heart failure syndrome. MethodThe Korean acute heart failure registry (KorAHF) is an on-going prospective multicenter cohort study for acute HF. As of November 2013, interim analysis of 4184 patients was performed. We categorized the study population into 4 groups by BMI value (kg/m2); BMI<18.5, 18.5≤BMI<25, 25≤BMI<30 and 30≤BMI. Study endpoint included all cause death and rehospitalization. The Korean acute heart failure registry (KorAHF) is an on-going prospective multicenter cohort study for acute HF. As of November 2013, interim analysis of 4184 patients was performed. We categorized the study population into 4 groups by BMI value (kg/m2); BMI<18.5, 18.5≤BMI<25, 25≤BMI<30 and 30≤BMI. Study endpoint included all cause death and rehospitalization. ResultsOf total 3618 patients, 549 (28.3%) and 489 (29.1%) reached study endpoints in men and women, respectively. After adjusting, the male patients with BMI≥30 showed the lowest risk (Hazard ratio [HR]: 0.472, 95% CI: 0.267-0.836, p=0.010) compared to those with BMI<18.5. This correlation between BMI and study endpoint was not remarkable in women. In male, patients with HF with reduced ejection fraction (EF<40%), patients with BMI≥30 showed the lowest risk (HR: 0.323, 95% CI: 0.138-0.755, p=0.009) for study endpoint compared to those with BMI<18.5. However this correlation was not noted in patients with preserved ejection fraction in male. Of total 3618 patients, 549 (28.3%) and 489 (29.1%) reached study endpoints in men and women, respectively. After adjusting, the male patients with BMI≥30 showed the lowest risk (Hazard ratio [HR]: 0.472, 95% CI: 0.267-0.836, p=0.010) compared to those with BMI<18.5. This correlation between BMI and study endpoint was not remarkable in women. In male, patients with HF with reduced ejection fraction (EF<40%), patients with BMI≥30 showed the lowest risk (HR: 0.323, 95% CI: 0.138-0.755, p=0.009) for study endpoint compared to those with BMI<18.5. However this correlation was not noted in patients with preserved ejection fraction in male. ConclusionsIn KorAHF registry, there was a gender difference of obesity paradox in patients with AHF. BMI was the independent risk factor for adverse cardiac events in men who have HF with reduced ejection fraction. In KorAHF registry, there was a gender difference of obesity paradox in patients with AHF. BMI was the independent risk factor for adverse cardiac events in men who have HF with reduced ejection fraction.