Sökning: WFRF:(Swedberg K)
> (2010-2014) >
The obesity paradox...
The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data
- Artikel/kapitelEngelska2014
Förlag, utgivningsår, omfång ...
-
2013-10-31
-
Springer Science and Business Media LLC,2014
Nummerbeteckningar
-
LIBRIS-ID:oai:gup.ub.gu.se/189074
-
https://gup.ub.gu.se/publication/189074URI
-
https://doi.org/10.1038/ijo.2013.203DOI
Kompletterande språkuppgifter
Ingår i deldatabas
Klassifikation
-
Ämneskategori:ref swepub-contenttype
-
Ämneskategori:art swepub-publicationtype
Anmärkningar
-
Background:In heart failure (HF), obesity, defined as body mass index (BMI) >/=30 kg m-2, is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).Patients and Methods:A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and >/=35 kg m-2. Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups.Results:BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m-2, the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI >/=35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI >/=35.Conclusions:In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m-2.International Journal of Obesity advance online publication, 26 November 2013; doi:10.1038/ijo.2013.203.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
-
McAlister, F. A.
(författare)
-
McMurray, J. J.
(författare)
-
Cowie, M. R.
(författare)
-
Rich, M.
(författare)
-
Pocock, S.
(författare)
-
Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xsweka
(författare)
-
Maggioni, A.
(författare)
-
Gamble, G.
(författare)
-
Ariti, C.
(författare)
-
Earle, N.
(författare)
-
Whalley, G.
(författare)
-
Poppe, K. K.
(författare)
-
Doughty, R. N.
(författare)
-
Bayes-Genis, A.
(författare)
-
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin
(creator_code:org_t)
Sammanhörande titlar
-
Ingår i:International Journal of Obesity: Springer Science and Business Media LLC38:8, s. 1110-11140307-05651476-5497
Internetlänk
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
-
Padwal, R.
-
McAlister, F. A.
-
McMurray, J. J.
-
Cowie, M. R.
-
Rich, M.
-
Pocock, S.
-
visa fler...
-
Swedberg, Karl, ...
-
Maggioni, A.
-
Gamble, G.
-
Ariti, C.
-
Earle, N.
-
Whalley, G.
-
Poppe, K. K.
-
Doughty, R. N.
-
Bayes-Genis, A.
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
- Artiklar i publikationen
-
International Jo ...
- Av lärosätet
-
Göteborgs universitet