Revisiting the obesity paradox in heart failure: Per cent body fat as predictor of biomarkers and outcome

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Revisiting the obesity paradox in heart failure : Per cent body fat as predictor of biomarkers and outcome

Aimo, Alberto (author): Univ Hosp Pisa, Cardiol Div, Pisa, Italy

Januzzi, James L., Jr. (author): Massachusetts Gen Hosp, Boston, MA 02114 USA;Baim Inst Clin Res, Boston, MA USA

Vergaro, Giuseppe (author): Scuola Super Sant Anna, Inst Life Sci, Pisa, Italy;Fdn Toscana G Monasterio, Pisa, Italy

Clerico, Aldo (author): Scuola Super Sant Anna, Inst Life Sci, Pisa, Italy;Fdn Toscana G Monasterio, Pisa, Italy

Latini, Roberto (author): IRCCS, Dept Cardiovasc Res, Ist Ric Farmacolog Mario Negri, Milan, Italy

Meessen, Jennifer (author): IRCCS, Dept Cardiovasc Res, Ist Ric Farmacolog Mario Negri, Milan, Italy

Anand, Inder S. (author): Univ Minnesota, Div Cardiovasc Med, Minneapolis, MN USA;VA Med Ctr, Dept Cardiol, Minneapolis, MN USA

Cohn, Jay N. (author): Univ Minnesota, Div Cardiovasc Med, Minneapolis, MN USA

Gravning, Jorgen (author): Oslo Univ Hosp, Dept Cardiol, Oslo, Norway;Univ Oslo, Ctr Heart Failure Res, Oslo, Norway

Ueland, Thor (author): Oslo Univ Hosp, Rikshosp, Res Inst Internal Med, Oslo, Norway;Univ Oslo, Fac Med, Oslo, Norway;Univ Tromso, KG Jebsen Thrombosis Res & Expertise Ctr, Tromso, Norway

Nymo, Stale H. (author): Oslo Univ Hosp, Rikshosp, Res Inst Internal Med, Oslo, Norway

Brunner-La Rocca, Hans-Peter (author): Maastricht Univ, Dept Cardiol, Med Ctr, Maastricht, Netherlands

Bayes-Genis, Antoni (author): Hosp Badalona Germans Trias & Pujol, Badalona, Barcelona, Spain

Lupon, Josep (author): Hosp Badalona Germans Trias & Pujol, Badalona, Barcelona, Spain

de Boer, Rudolf A. (author): Univ Med Ctr Groningen, Groningen, Netherlands

Yoshihisa, Akiomi (author): Fukushima Med Univ, Dept Cardiovasc Med, Fukushima, Japan

Takeishi, Yasuchika (author): Fukushima Med Univ, Dept Cardiovasc Med, Fukushima, Japan

Egstrup, Michael (author): Copenhagen Univ Hosp, Dept Cardiol, Rigshosp, Copenhagen, Denmark

Gustafsson, Ida (author): Copenhagen Univ Hosp, Dept Cardiol, Rigshosp, Copenhagen, Denmark

Gagging, Hanna K. (author): Massachusetts Gen Hosp, Boston, MA 02114 USA;Baim Inst Clin Res, Boston, MA USA

Eggers, Kai M., 1962- (author): Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)

Huber, Kurt (author): Wilhelminenspital & Sigmund Freud Univ, Fac Internal Med, Med Sch, Vienna, Austria

Tentzeris, Ioannis (author): Wilhelminenspital & Sigmund Freud Univ, Fac Internal Med, Med Sch, Vienna, Austria

Ripoli, Andrea (author): Fdn Toscana G Monasterio, Pisa, Italy

Passino, Claudio (author): Scuola Super Sant Anna, Inst Life Sci, Pisa, Italy;Fdn Toscana G Monasterio, Pisa, Italy

Emdin, Michele (author): Scuola Super Sant Anna, Inst Life Sci, Pisa, Italy;Fdn Toscana G Monasterio, Pisa, Italy

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2019-06-01
2019
English.
In: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 26:16, s. 1751-1759

Related links:: https://munin.uit.no...; show more...; https://urn.kb.se/re...; https://doi.org/10.1...; show less...

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Aims Obesity defined by body mass index (BMI) is characterized by better prognosis and lower plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in heart failure. We assessed whether another anthropometric measure, per cent body fat (PBF), reveals different associations with outcome and heart failure biomarkers (NT-proBNP, high-sensitivity troponin T (hs-TnT), soluble suppression of tumorigenesis-2 (sST2)). Methods In an individual patient dataset, BMI was calculated as weight (kg)/height (m) (2) , and PBF through the Jackson-Pollock and Gallagher equations. Results Out of 6468 patients (median 68 years, 78% men, 76% ischaemic heart failure, 90% reduced ejection fraction), 24% died over 2.2 years (1.5-2.9), 17% from cardiovascular death. Median PBF was 26.9% (22.4-33.0%) with the Jackson-Pollock equation, and 28.0% (23.8-33.5%) with the Gallagher equation, with an extremely strong correlation (r = 0.996, p < 0.001). Patients in the first PBF tertile had the worst prognosis, while patients in the second and third tertile had similar survival. The risks of all-cause and cardiovascular death decreased by up to 36% and 27%, respectively, per each doubling of PBF. Furthermore, prognosis was better in the second or third PBF tertiles than in the first tertile regardless of model variables. Both BMI and PBF were inverse predictors of NT-proBNP, but not hs-TnT. In obese patients (BMI >= 30 kg/m(2), third PBF tertile), hs-TnT and sST2, but not NT-proBNP, independently predicted outcome. Conclusion In parallel with increasing BMI or PBF there is an improvement in patient prognosis and a decrease in NT-proBNP, but not hs-TnT or sST2. hs-TnT or sST2 are stronger predictors of outcome than NT-proBNP among obese patients.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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Revisiting the obesity paradox in heart failure : Per cent body fat as predictor of biomarkers and outcome

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