Body surface area as a prognostic marker in chronic heart failure patients: results from the Heart Failure Registry of the Heart Failure Association of the European Society of Cardiology
Aims The ‘obesity paradox’ is consistently observed in patients with heart failure (HF). We investigated the relationship of body surface area (BSA) to mortality and hospitalizations in patients with chronic HF. Methods and results Data from the outpatient cohort of the observational, prospective, H...
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| Veröffentlicht in: | European journal of heart failure 2016-07, Vol.18 (7), p.859-868 |
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| creator | Zafrir, Barak Salman, Nabeeh Crespo-Leiro, Maria G. Anker, Stefan D. Coats, Andrew J. Ferrari, Roberto Filippatos, Gerasimos Maggioni, Aldo P. Mebazaa, Alexandre Piepoli, Massimo Francesco Ruschitzka, Frank Paniagua-Martin, Maria J. Segovia, Javier Laroche, Cecile Amir, Offer |
| description | Aims
The ‘obesity paradox’ is consistently observed in patients with heart failure (HF). We investigated the relationship of body surface area (BSA) to mortality and hospitalizations in patients with chronic HF.
Methods and results
Data from the outpatient cohort of the observational, prospective, Heart Failure Long‐Term Registry of the Heart Failure Association of the European Society of Cardiology was analysed in order to evaluate the prognostic significance of BSA in chronic HF. A total of 9104 chronic HF patients (age 64.8 ± 13.4 years; 71.6% males) were enrolled. Mortality during 1‐year follow‐up was observed in 718 of 8875 (8.1%) patients. A progressive, inverse relationship between all‐cause mortality and BSA levels was observed; the adjusted hazard ratio (HR) for 1‐year mortality was 1.823 [95% confidence interval (CI) 1.398–2.376], P < 0.001 for the lowest quartile of BSA 2.07 m2). For each increase of 0.1 m2 in BSA, an adjusted HR of 0.908 (95% CI 0.870–0.948), P < 0.001 for mortality was calculated. HF hospitalizations were not associated with BSA subgroup distribution. In both genders, subjects within the lowest BSA quartile (males |
| doi_str_mv | 10.1002/ejhf.551 |
| format | Article |
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The ‘obesity paradox’ is consistently observed in patients with heart failure (HF). We investigated the relationship of body surface area (BSA) to mortality and hospitalizations in patients with chronic HF.
Methods and results
Data from the outpatient cohort of the observational, prospective, Heart Failure Long‐Term Registry of the Heart Failure Association of the European Society of Cardiology was analysed in order to evaluate the prognostic significance of BSA in chronic HF. A total of 9104 chronic HF patients (age 64.8 ± 13.4 years; 71.6% males) were enrolled. Mortality during 1‐year follow‐up was observed in 718 of 8875 (8.1%) patients. A progressive, inverse relationship between all‐cause mortality and BSA levels was observed; the adjusted hazard ratio (HR) for 1‐year mortality was 1.823 [95% confidence interval (CI) 1.398–2.376], P < 0.001 for the lowest quartile of BSA <1.78 m2, and 1.255, 95% CI 1.000–1.576, P = 0.05 for the middle two quartiles (1.78 ≤BSA ≤2.07 m2), compared with the highest quartile (BSA >2.07 m2). For each increase of 0.1 m2 in BSA, an adjusted HR of 0.908 (95% CI 0.870–0.948), P < 0.001 for mortality was calculated. HF hospitalizations were not associated with BSA subgroup distribution. In both genders, subjects within the lowest BSA quartile (males <1.84 m2 and females <1.64 m2) had significantly higher mortality rates during follow‐up (log‐rank P < 0.0001). However, the stepwise association with mortality was more distinct in males.
Conclusions
Total and cardiovascular mortality, but not HF hospitalizations was inversely associated with BSA levels in chronic HF patients. BSA may serve as a prognostic indicator for adverse outcome in HF patients.]]></description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1002/ejhf.551</identifier><identifier>PMID: 27198159</identifier><language>eng</language><publisher>Oxford, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Aged, 80 and over ; Body Surface Area ; Cardiology ; Cardiovascular Diseases - mortality ; Cause of Death ; Chronic Disease ; Cohort Studies ; Comorbidity ; Europe - epidemiology ; Female ; Follow-Up Studies ; Heart failure ; Heart Failure - epidemiology ; Heart Failure - mortality ; Hospitalization - statistics & numerical data ; Humans ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Obesity ; Obesity - epidemiology ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Registries ; Sex Factors ; Societies, Medical</subject><ispartof>European journal of heart failure, 2016-07, Vol.18 (7), p.859-868</ispartof><rights>2016 The Authors. © 2016 European Society of Cardiology</rights><rights>2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5291-3bc58c2bfe159a83045d2019f19abad07a8a819e9e84b0037b71381ba69d86323</citedby><cites>FETCH-LOGICAL-c5291-3bc58c2bfe159a83045d2019f19abad07a8a819e9e84b0037b71381ba69d86323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fejhf.551$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fejhf.551$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,1432,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27198159$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zafrir, Barak</creatorcontrib><creatorcontrib>Salman, Nabeeh</creatorcontrib><creatorcontrib>Crespo-Leiro, Maria G.</creatorcontrib><creatorcontrib>Anker, Stefan D.</creatorcontrib><creatorcontrib>Coats, Andrew J.</creatorcontrib><creatorcontrib>Ferrari, Roberto</creatorcontrib><creatorcontrib>Filippatos, Gerasimos</creatorcontrib><creatorcontrib>Maggioni, Aldo P.</creatorcontrib><creatorcontrib>Mebazaa, Alexandre</creatorcontrib><creatorcontrib>Piepoli, Massimo Francesco</creatorcontrib><creatorcontrib>Ruschitzka, Frank</creatorcontrib><creatorcontrib>Paniagua-Martin, Maria J.</creatorcontrib><creatorcontrib>Segovia, Javier</creatorcontrib><creatorcontrib>Laroche, Cecile</creatorcontrib><creatorcontrib>Amir, Offer</creatorcontrib><creatorcontrib>Heart Failure Long-Term Registry Investigators</creatorcontrib><creatorcontrib>on behalf of the Heart Failure Long‐Term Registry Investigators</creatorcontrib><title>Body surface area as a prognostic marker in chronic heart failure patients: results from the Heart Failure Registry of the Heart Failure Association of the European Society of Cardiology</title><title>European journal of heart failure</title><addtitle>Eur J Heart Fail</addtitle><description><![CDATA[Aims
The ‘obesity paradox’ is consistently observed in patients with heart failure (HF). We investigated the relationship of body surface area (BSA) to mortality and hospitalizations in patients with chronic HF.
Methods and results
Data from the outpatient cohort of the observational, prospective, Heart Failure Long‐Term Registry of the Heart Failure Association of the European Society of Cardiology was analysed in order to evaluate the prognostic significance of BSA in chronic HF. A total of 9104 chronic HF patients (age 64.8 ± 13.4 years; 71.6% males) were enrolled. Mortality during 1‐year follow‐up was observed in 718 of 8875 (8.1%) patients. A progressive, inverse relationship between all‐cause mortality and BSA levels was observed; the adjusted hazard ratio (HR) for 1‐year mortality was 1.823 [95% confidence interval (CI) 1.398–2.376], P < 0.001 for the lowest quartile of BSA <1.78 m2, and 1.255, 95% CI 1.000–1.576, P = 0.05 for the middle two quartiles (1.78 ≤BSA ≤2.07 m2), compared with the highest quartile (BSA >2.07 m2). For each increase of 0.1 m2 in BSA, an adjusted HR of 0.908 (95% CI 0.870–0.948), P < 0.001 for mortality was calculated. HF hospitalizations were not associated with BSA subgroup distribution. In both genders, subjects within the lowest BSA quartile (males <1.84 m2 and females <1.64 m2) had significantly higher mortality rates during follow‐up (log‐rank P < 0.0001). However, the stepwise association with mortality was more distinct in males.
Conclusions
Total and cardiovascular mortality, but not HF hospitalizations was inversely associated with BSA levels in chronic HF patients. BSA may serve as a prognostic indicator for adverse outcome in HF patients.]]></description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Surface Area</subject><subject>Cardiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cause of Death</subject><subject>Chronic Disease</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart failure</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - mortality</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Obesity</subject><subject>Obesity - epidemiology</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Sex Factors</subject><subject>Societies, Medical</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdFu0zAUhi0EYmMg8QTIl9xk2Enc2NyNql2ZBkgwNO6sE-e49UjjYjuCvBpPh7d24waubPl8_qTz_4S85OyUM1a-wZuNPRWCPyLHXDaqYLKuH-d7JWWhZF0ekWcx3jDGm0w_JUdlw5XkQh2T3-98N9E4BgsGKQQECpEC3QW_HnxMztAthO8YqBuo2QQ_5JcNQkjUguvHgHQHyeGQ4lsaMI59itQGv6Vpg3R1By4P4Gdcu5jCRL39x_QsRm9cdvnhHliMwe8QBvolTzDdfZxD6Jzv_Xp6Tp5Y6CO-OJwn5OtycTVfFZefzt_Pzy4LI0rFi6o1QpqytZgXBlmxWnQl48pyBS10rAEJkitUKOuWsappm5wbb2GmOjmryuqEvN57cyY_RoxJb1002PcwoB-j5pKJWjb1jP1FTfAxBrR6F1zOb9Kc6dum9G1TOjeV0VcH69husXsA76vJQLEHfroep_-K9OJitdwLD3zOGH898Lk8PWuqRujrj-f64ur6w7dlqbSo_gAoza9H</recordid><startdate>201607</startdate><enddate>201607</enddate><creator>Zafrir, Barak</creator><creator>Salman, Nabeeh</creator><creator>Crespo-Leiro, Maria G.</creator><creator>Anker, Stefan D.</creator><creator>Coats, Andrew J.</creator><creator>Ferrari, Roberto</creator><creator>Filippatos, Gerasimos</creator><creator>Maggioni, Aldo P.</creator><creator>Mebazaa, Alexandre</creator><creator>Piepoli, Massimo Francesco</creator><creator>Ruschitzka, Frank</creator><creator>Paniagua-Martin, Maria J.</creator><creator>Segovia, Javier</creator><creator>Laroche, Cecile</creator><creator>Amir, Offer</creator><general>John Wiley & Sons, Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201607</creationdate><title>Body surface area as a prognostic marker in chronic heart failure patients: results from the Heart Failure Registry of the Heart Failure Association of the European Society of Cardiology</title><author>Zafrir, Barak ; Salman, Nabeeh ; Crespo-Leiro, Maria G. ; Anker, Stefan D. ; Coats, Andrew J. ; Ferrari, Roberto ; Filippatos, Gerasimos ; Maggioni, Aldo P. ; Mebazaa, Alexandre ; Piepoli, Massimo Francesco ; Ruschitzka, Frank ; Paniagua-Martin, Maria J. ; Segovia, Javier ; Laroche, Cecile ; Amir, Offer</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5291-3bc58c2bfe159a83045d2019f19abad07a8a819e9e84b0037b71381ba69d86323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body Surface Area</topic><topic>Cardiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cause of Death</topic><topic>Chronic Disease</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart failure</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - mortality</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Obesity</topic><topic>Obesity - epidemiology</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Sex Factors</topic><topic>Societies, Medical</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zafrir, Barak</creatorcontrib><creatorcontrib>Salman, Nabeeh</creatorcontrib><creatorcontrib>Crespo-Leiro, Maria G.</creatorcontrib><creatorcontrib>Anker, Stefan D.</creatorcontrib><creatorcontrib>Coats, Andrew J.</creatorcontrib><creatorcontrib>Ferrari, Roberto</creatorcontrib><creatorcontrib>Filippatos, Gerasimos</creatorcontrib><creatorcontrib>Maggioni, Aldo P.</creatorcontrib><creatorcontrib>Mebazaa, Alexandre</creatorcontrib><creatorcontrib>Piepoli, Massimo Francesco</creatorcontrib><creatorcontrib>Ruschitzka, Frank</creatorcontrib><creatorcontrib>Paniagua-Martin, Maria J.</creatorcontrib><creatorcontrib>Segovia, Javier</creatorcontrib><creatorcontrib>Laroche, Cecile</creatorcontrib><creatorcontrib>Amir, Offer</creatorcontrib><creatorcontrib>Heart Failure Long-Term Registry Investigators</creatorcontrib><creatorcontrib>on behalf of the Heart Failure Long‐Term Registry Investigators</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zafrir, Barak</au><au>Salman, Nabeeh</au><au>Crespo-Leiro, Maria G.</au><au>Anker, Stefan D.</au><au>Coats, Andrew J.</au><au>Ferrari, Roberto</au><au>Filippatos, Gerasimos</au><au>Maggioni, Aldo P.</au><au>Mebazaa, Alexandre</au><au>Piepoli, Massimo Francesco</au><au>Ruschitzka, Frank</au><au>Paniagua-Martin, Maria J.</au><au>Segovia, Javier</au><au>Laroche, Cecile</au><au>Amir, Offer</au><aucorp>Heart Failure Long-Term Registry Investigators</aucorp><aucorp>on behalf of the Heart Failure Long‐Term Registry Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body surface area as a prognostic marker in chronic heart failure patients: results from the Heart Failure Registry of the Heart Failure Association of the European Society of Cardiology</atitle><jtitle>European journal of heart failure</jtitle><addtitle>Eur J Heart Fail</addtitle><date>2016-07</date><risdate>2016</risdate><volume>18</volume><issue>7</issue><spage>859</spage><epage>868</epage><pages>859-868</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract><![CDATA[Aims
The ‘obesity paradox’ is consistently observed in patients with heart failure (HF). We investigated the relationship of body surface area (BSA) to mortality and hospitalizations in patients with chronic HF.
Methods and results
Data from the outpatient cohort of the observational, prospective, Heart Failure Long‐Term Registry of the Heart Failure Association of the European Society of Cardiology was analysed in order to evaluate the prognostic significance of BSA in chronic HF. A total of 9104 chronic HF patients (age 64.8 ± 13.4 years; 71.6% males) were enrolled. Mortality during 1‐year follow‐up was observed in 718 of 8875 (8.1%) patients. A progressive, inverse relationship between all‐cause mortality and BSA levels was observed; the adjusted hazard ratio (HR) for 1‐year mortality was 1.823 [95% confidence interval (CI) 1.398–2.376], P < 0.001 for the lowest quartile of BSA <1.78 m2, and 1.255, 95% CI 1.000–1.576, P = 0.05 for the middle two quartiles (1.78 ≤BSA ≤2.07 m2), compared with the highest quartile (BSA >2.07 m2). For each increase of 0.1 m2 in BSA, an adjusted HR of 0.908 (95% CI 0.870–0.948), P < 0.001 for mortality was calculated. HF hospitalizations were not associated with BSA subgroup distribution. In both genders, subjects within the lowest BSA quartile (males <1.84 m2 and females <1.64 m2) had significantly higher mortality rates during follow‐up (log‐rank P < 0.0001). However, the stepwise association with mortality was more distinct in males.
Conclusions
Total and cardiovascular mortality, but not HF hospitalizations was inversely associated with BSA levels in chronic HF patients. BSA may serve as a prognostic indicator for adverse outcome in HF patients.]]></abstract><cop>Oxford, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>27198159</pmid><doi>10.1002/ejhf.551</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of heart failure, 2016-07, Vol.18 (7), p.859-868 |
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| subjects | Aged Aged, 80 and over Body Surface Area Cardiology Cardiovascular Diseases - mortality Cause of Death Chronic Disease Cohort Studies Comorbidity Europe - epidemiology Female Follow-Up Studies Heart failure Heart Failure - epidemiology Heart Failure - mortality Hospitalization - statistics & numerical data Humans Male Middle Aged Mortality Multivariate Analysis Obesity Obesity - epidemiology Prognosis Proportional Hazards Models Prospective Studies Registries Sex Factors Societies, Medical |
| title | Body surface area as a prognostic marker in chronic heart failure patients: results from the Heart Failure Registry of the Heart Failure Association of the European Society of Cardiology |
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