ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Revisiting the obesity paradox in patients with heart failure with reduced ejection fraction in the light of contemporary guideline-directed medical therapy.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe presence of higher body mass index (BMI) accompanied by better outcomes in patients with heart failure with reduced ejection fraction (HFrEF) is described as the obesity paradox. However, recent evidence has questioned the existence of this phenomenon by adjusting for better prognostic factors and using superior anthropometric measures of obesity. Nevertheless, data regarding the association between BMI and mortality in HFrEF patients with the use of contemporary guideline-directed medical therapy (GDMT), including SGLT2is, is scarce.
aimTo assess the association between BMI and mortality in patients with HFrEF treated with modern GDMT across a wide BMI spectrum. PATIENTS AND
methodsThe data of 420 consecutive patients (male sex: 75%, age: 62 [51-71] years, NT-proBNP at admission: 5678 [2647-10501] pg/mL, LVEF: 24 [20-30] %, coronary artery disease: 44%, atrial fibrillation: 45%, normal weight: 33% [group 1: BMI < 25 kg/m
resultsAt hospital discharge, triple therapy (TT: RASi + βB + MRA) was applied in 82% (RASi: 92%, βB: 85%, MRA: 95%), while quadruple therapy (QT: TT + SGLT2i) was implemented in 58% of the total cohort (SGLT2i use: 64%). At discharge, higher BMI category was significantly (p < 0.05) associated with increased use of MRA (group 1, 2, 3: 93%, 92%, and 100%), SGLT2i medications (group 1, 2, 3: 58%, 61%, and 71%), and QT (group 1, 2, 3: 51%, 56%, and 65%). During a median follow-up of 534 days, ACM was lower with increasing BMI subgroup category (p = 0.021). In the multivariate analysis, BMI subgroup category was not associated with ACM, whereas age, T2D, peripheral artery disease, NT-proBNP at discharge, and use of QT at discharge were independent predictors of ACM. In the sensitivity analysis, no significant differences were seen in the ACM of each BMI category after PSM.
conclusionsIn a consecutive cohort of patients hospitalised due to HFrEF with high rates of modern GDMT use across a wide BMI spectrum, higher BMI subgroup category was not associated with better survival after adjustment for comorbidities and prognostic factors.
Indexed as
Identifiers
41874605What Socratic holds
Registered trials
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.