Observational studyCardiovascular diabetology2026
Associations of body mass index on worsening of heart failure and mortality in patients with heart failure and reduced left ventricular ejection fraction: a 10-year follow-up study (a NorthStar substudy).
Observational study in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundObesity is prevalent in patients with heart failure with reduced ejection fraction (HFrEF). With the advent of glucagon-like peptide 1 analogues, understanding the relationship between body mass index (BMI) and clinical outcomes in HFrEF is crucial.
objectiveThis study investigated whether a BMI > 27 kg/m
methodsA total of 1017 clinically stable and medically optimized HFrEF patients from the NorthStar study (enrolled 2005-2009) were analyzed. Patients were followed until 2023 using Danish nationwide registries. The primary outcome was all-cause mortality, while secondary outcomes included cardiovascular mortality, HF hospitalization, and a composite of all-cause mortality or HF hospitalization. Cox proportional-hazards models adjusted for prognostic factors were used to assess associations. Interaction analyses for the primary outcome were conducted for BMI categories (< 24, 24-27, > 27 kg/m
resultsCompared to patients with a BMI of 24-27 kg/m
conclusionIn HFrEF patients, a BMI > 27 was not associated with increased mortality, contradicting the "obesity-survival paradox." In fact, patients with ischemic cardiomyopathy and a BMI > 27 may be associated with a higher mortality rate.
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