Revista argentina de cardiología
versión On-line ISSN 1850-3748
FERNANDEZ, Alberto et al. Prognostic Value of Body Mass Index in Patients with Chronic Heart Failure: the GESICA Registry. Rev. argent. cardiol. [online]. 2006, vol.74, n.4, pp. 204-210. ISSN 1850-3748.
Objectives The study objectives were to compare the clinical characteristics of patients (p) with heart failure (HF) according to their body mass index (BMI), to test if BMI was related to prognosis, to describe this association with mortality and to assess whether its impact varied in different subgroups of p. Material and methods In a cohort of 2331 ambulatory patients with HF, clinical characteristics were compared according to BMI. The association between mortality and BMI was tested with univariate and multivariate analyses including potential confounding factors (Cox regression). The relationship between BMI and mortality was described. A subanalysis was performed in p with morbid obesity. The impact of BMI was tested in p subgroups. Mean follow up was 957 days. Results The population, according to BMI categories, was grouped as follows: <20 kg/m2, 61 p (2.61%); 20 - 24.99 kg/m2, 668 p (28.65%); 25 - 29.99 kg/m2, 999 p (42.85%); and 30 kg/m2 or higher, 603 p (25.86%). A higher BMI was related to less severe HF and lower mortality. A multivariate analysis showed: BMI < 20 kg/m2: HR 1.72 (1.14 - 2.59, p=0.009), BMI 25 - 29.99 kg/m2: HR 0.78 (0.64-0.95, p=0.015), BMI≥ 30 kg/m2: HR 0.79 (0.63 - 0.99, p=0.047). The effect of a low BMI (<24 kg/m2) was lower in patients with chronic renal failure, treated with beta blockers or statins. Morbid obesity (BMI >35 kg/m2) was associated with a lower mortality. Conclusions The BMI provides additional prognostic information in ambulatory p with HF. Its prognostic value is similar in different subgroups of p according to left ventricular function, time from diagnosis and comorbid conditions. Key words: Body mass index; Heart failure; Obesity; Prognosis.
Palabras clave : Insuficiencia cardíaca; Índice de masa corporal; Mortalidad.