SynthesisClinical research in cardiology : official journal of the German Cardiac Society2021
Re-appraisal of the obesity paradox in heart failure: a meta-analysis of individual data.
Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 41 citations in OpenAlex.
- Association of Body Mass Index and Abdominal Obesity with Incidence of Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction.Current medicinal chemistry · 2025Trial
- Body Mass Index, Clinical Outcomes, and Mortality in Heart Failure: A Mendelian Randomization Study.Journal of the American College of Cardiology · 2026Article
- Cardiogenic Shock: Outcome Patterns Across the Body Mass Spectrum and Renal Vulnerability.Cardiology · 2026Article
- Redefining heart failure subtypes according to skeletal muscle mass.Nature reviews. Cardiology · 2026Article
- Do obesity and visceral adiposity promote heart failure with reduced ejection fraction?European heart journal · 2026Review
- Observational
- Central Adiposity or Hypertension: Which Drives Heart Failure With a Preserved Ejection Fraction?Journal of the American College of Cardiology · 2025Review
- The association between triglyceride glucose-body mass index and all-cause mortality in critically ill patients undergoing cardiac surgery: a retrospective analysis from the MIMIC-IV database.BMC cardiovascular disorders · 2025Article
- Prognostic Impact of Obesity, Cardiometabolic Risk Factors, and Vascular Function Markers on Outcomes in Ischemic Cardiomyopathy.Journal of clinical medicine · 2025Article
- Article
- Navigating Sarcopenia Risks in GLP-1RA Therapy for Advanced Heart Failure.Biomedicines · 2025Review
- Mediation effect analysis of lipoprotein levels on BMI and cardiovascular outcomes in patients with heart failure.BMC cardiovascular disorders · 2024Observational
- Lipoprotein Insulin Resistance Score and Mortality Risk Stratification in Heart Failure.The American journal of medicine · 2024Article
- Value of the triglyceride-glucose index and related parameters in heart failure patients.Frontiers in cardiovascular medicine · 2024Review
- Association of body mass index and long-term mortality in patients from nationwide LIPIDOGRAM 2004-2015 cohort studies: no obesity paradox?Cardiovascular diabetology · 2023Article
- Body mass index and survival in people with heart failure.Heart (British Cardiac Society) · 2023Article
- Effect of body mass index on N-terminal pro-brain natriuretic peptide values in patients with heart failure.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2023Article
- Diuretics, SGLT2 inhibitors and falls in older heart failure patients: to prescribe or to deprescribe? A clinical review.European geriatric medicine · 2023Review
- Is the obesity paradox in outpatients with heart failure reduced ejection fraction real?Frontiers in cardiovascular medicine · 2023Article
- Article
Corrections and comments
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Authors and funding
27 authors at 14 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigher body mass index (BMI) is associated with better outcome compared with normal weight in patients with HF and other chronic diseases. It remains uncertain whether the apparent protective role of obesity relates to the absence of comorbidities. Therefore, we investigated the effect of BMI on outcome in younger patients without co-morbidities as compared to older patients with co-morbidities in a large heart failure (HF) population.
methodsIn an individual patient data analysis from pooled cohorts, 5,819 patients with chronic HF and data available on BMI, co-morbidities and outcome were analysed. Patients were divided into four groups based on BMI (i.e. ≤ 18.5 kg/m
resultsMean age was 65 ± 12 years, with a majority of males (78%), ischaemic HF and HF with reduced ejection fraction. Frequency of all-cause mortality or HF hospitalization was significantly worse in the lowest two BMI groups as compared to the other two groups; however, this effect was only seen in patients older than 75 years or having at least one relevant co-morbidity, and not in younger patients with HF only. After including medications and N-terminal pro-B-type natriuretic peptide and high-sensitivity cardiac troponin concentrations into the model, the prognostic impact of BMI was largely absent even in the elderly group with co-morbidity.
conclusionsThe present study suggests that obesity is a marker of less advanced disease, but does not have an independent protective effect in patients with chronic HF. Categories of BMI are only predictive of poor outcome in patients aged > 75 years or with at least one co-morbidity (bottom), but not in those aged < 75 years without co-morbidities (top). The prognostic effect largely disappears in multivariable analyses even for the former group. These findings question the protective effect of obesity in chronic heart failure (HF).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.