Body mass index, prognosis and mode of death in chronic heart failure

Results from the Valsartan Heart Failure Trial

Mariantonietta Cicoira, Aldo Pietro Maggioni, Roberto Latini, Simona Barlera, Elisa Carretta, Andras Janosi, Jordi Soler Soler, Inder Anand, Jay N. Cohn

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Aims: To assess the relationship between body mass index (BMI), mortality and mode of death in chronic heart failure (CHF) patients; to define the shape of the relationship between BMI and mortality. Methods and results: We performed a post-hoc analysis of 5010 patients from the Valsartan Heart Failure Trial. The end-points of the study were all-cause and cardiovascular mortality. Mortality rate was 27.2% in underweight patients (BMI < 22 kg/m2), 21.7% in normal weight patients (BMI 22-24.9 kg/m2), 17.9% in overweight patients (BMI 25-29.9 kg/m2) and 16.5% in obese patients (BMI > 30 kg/m2) (p < 0.0001). The rates of non-cardiovascular death did not differ among groups. The risk of death due to progressive heart failure was 3.4-fold higher in the underweight than in the obese patients (p < 0.0001). Normal weight, overweight and obese patients had lower risk of death as compared with underweight patients (p = 0.019, HR 0.76, 95% CI 0.61-0.96; p = 0.0005, HR 0.68, 95% CI 0.55-0.84; p = 0.003, HR 0.67, 95% CI 0.52-0.88, respectively) independently of symptoms, ventricular function, beta-blocker use, C-reactive protein and brain natriuretic peptide levels. Conclusions: In CHF patients a higher BMI is associated with a better prognosis independently of other clinical variables. The relationship between mortality and BMI is monotonically decreasing.

Original languageEnglish (US)
Pages (from-to)397-402
Number of pages6
JournalEuropean Journal of Heart Failure
Volume9
Issue number4
DOIs
StatePublished - Apr 1 2007

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Valsartan
Body Mass Index
Heart Failure
Thinness
Mortality
Ventricular Function
Brain Natriuretic Peptide
C-Reactive Protein

Keywords

  • Body mass index
  • Heart failure
  • Prognosis

Cite this

Body mass index, prognosis and mode of death in chronic heart failure : Results from the Valsartan Heart Failure Trial. / Cicoira, Mariantonietta; Maggioni, Aldo Pietro; Latini, Roberto; Barlera, Simona; Carretta, Elisa; Janosi, Andras; Soler Soler, Jordi; Anand, Inder; Cohn, Jay N.

In: European Journal of Heart Failure, Vol. 9, No. 4, 01.04.2007, p. 397-402.

Research output: Contribution to journalArticle

Cicoira, M, Maggioni, AP, Latini, R, Barlera, S, Carretta, E, Janosi, A, Soler Soler, J, Anand, I & Cohn, JN 2007, 'Body mass index, prognosis and mode of death in chronic heart failure: Results from the Valsartan Heart Failure Trial', European Journal of Heart Failure, vol. 9, no. 4, pp. 397-402. https://doi.org/10.1016/j.ejheart.2006.10.016
Cicoira, Mariantonietta ; Maggioni, Aldo Pietro ; Latini, Roberto ; Barlera, Simona ; Carretta, Elisa ; Janosi, Andras ; Soler Soler, Jordi ; Anand, Inder ; Cohn, Jay N. / Body mass index, prognosis and mode of death in chronic heart failure : Results from the Valsartan Heart Failure Trial. In: European Journal of Heart Failure. 2007 ; Vol. 9, No. 4. pp. 397-402.
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AU - Latini, Roberto

AU - Barlera, Simona

AU - Carretta, Elisa

AU - Janosi, Andras

AU - Soler Soler, Jordi

AU - Anand, Inder

AU - Cohn, Jay N.

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N2 - Aims: To assess the relationship between body mass index (BMI), mortality and mode of death in chronic heart failure (CHF) patients; to define the shape of the relationship between BMI and mortality. Methods and results: We performed a post-hoc analysis of 5010 patients from the Valsartan Heart Failure Trial. The end-points of the study were all-cause and cardiovascular mortality. Mortality rate was 27.2% in underweight patients (BMI < 22 kg/m2), 21.7% in normal weight patients (BMI 22-24.9 kg/m2), 17.9% in overweight patients (BMI 25-29.9 kg/m2) and 16.5% in obese patients (BMI > 30 kg/m2) (p < 0.0001). The rates of non-cardiovascular death did not differ among groups. The risk of death due to progressive heart failure was 3.4-fold higher in the underweight than in the obese patients (p < 0.0001). Normal weight, overweight and obese patients had lower risk of death as compared with underweight patients (p = 0.019, HR 0.76, 95% CI 0.61-0.96; p = 0.0005, HR 0.68, 95% CI 0.55-0.84; p = 0.003, HR 0.67, 95% CI 0.52-0.88, respectively) independently of symptoms, ventricular function, beta-blocker use, C-reactive protein and brain natriuretic peptide levels. Conclusions: In CHF patients a higher BMI is associated with a better prognosis independently of other clinical variables. The relationship between mortality and BMI is monotonically decreasing.

AB - Aims: To assess the relationship between body mass index (BMI), mortality and mode of death in chronic heart failure (CHF) patients; to define the shape of the relationship between BMI and mortality. Methods and results: We performed a post-hoc analysis of 5010 patients from the Valsartan Heart Failure Trial. The end-points of the study were all-cause and cardiovascular mortality. Mortality rate was 27.2% in underweight patients (BMI < 22 kg/m2), 21.7% in normal weight patients (BMI 22-24.9 kg/m2), 17.9% in overweight patients (BMI 25-29.9 kg/m2) and 16.5% in obese patients (BMI > 30 kg/m2) (p < 0.0001). The rates of non-cardiovascular death did not differ among groups. The risk of death due to progressive heart failure was 3.4-fold higher in the underweight than in the obese patients (p < 0.0001). Normal weight, overweight and obese patients had lower risk of death as compared with underweight patients (p = 0.019, HR 0.76, 95% CI 0.61-0.96; p = 0.0005, HR 0.68, 95% CI 0.55-0.84; p = 0.003, HR 0.67, 95% CI 0.52-0.88, respectively) independently of symptoms, ventricular function, beta-blocker use, C-reactive protein and brain natriuretic peptide levels. Conclusions: In CHF patients a higher BMI is associated with a better prognosis independently of other clinical variables. The relationship between mortality and BMI is monotonically decreasing.

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