P5669Prognostic impact of low body-mass index in elderly patients with heart failure

Abstract Background Sarcopenia and malnutrition are associated with mortality in elderly patients with heart failure (HF). However, impact of phenotypic difference of sarcopenia on mortality is not well investigated. We hypothesized that evaluation using both body mass index (BMI) and free-fat mass index (FFMI) enabled distinction of phenotypic difference of sarcopenia and risk stratification for mortality in elderly patients with heart failure. Methods In 800 patients who discharged after treatment for HF were prospectively enrolled from 13 medical centers. Body mass index and FFMI was evaluated. Free-fat mass index was calculated dividing the square of the patients' heights in meters into lean body mass. All-cause mortality was followed-up. Patients were divided into 3 subgroups according to BMI and FFMI values, and compared incidence of mortality among them. Results In our study cohort (median age, 78 [range 72–87]), BMI was 21.1 [18.9, 23.8] and FFMI was 16.7 [15.2, 18.0]. 211 patients were experienced all-cause mortality during 631 [266, 983] days follow-up. In Kaplan-Meier analysis, lower BMI and lower FFMI was associated with all-cause mortality (Log-rank p<0.001, p<0.001, respectively). Furthermore, FFMI was an independent predictor of adverse events after adjustment for age, gender, albumin, hemoglobin, creatinine, brain natriuretic peptide, and left ventricular ejection fraction (HR 95% CI: 0.841 (0.745–0.944), p=0.004). In subgroup analysis, comparing with low-BMI and low-FFMI subgroup, better prognosis was observed in the other 2 subgroups (Log-rank p<0.001, p=0.022, Figure 1). Conclusions Phenotypic difference was evident in elderly patients with HF. A combination of BMI and FFMI would be useful for risk stratification of mortality in those patients. Figure 1 Funding Acknowledgement Type of funding source: None

Download Full-text

Association of Body Mass Index With Clinical Outcomes in Patients With Heart Failure With Reduced Ejection Fraction Treated With Sacubitril/Valsartan

Journal of Cardiovascular Pharmacology and Therapeutics ◽

10.1177/10742484211024441 ◽

2021 ◽

pp. 107424842110244

Author(s):

Kazuhiko Kido ◽

Christopher Bianco ◽

Marco Caccamo ◽

Wei Fang ◽

George Sokos

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Propensity Score ◽

Ejection Fraction ◽

Clinical Outcomes ◽

Body Mass ◽

Normal Weight ◽

Reduced Ejection Fraction ◽

Propensity Score Weighting ◽

Patients With Heart Failure

Background: Only limited data are available that address the association between body mass index (BMI) and clinical outcomes in patients with heart failure with reduced ejection fraction who are receiving sacubitril/valsartan. Methods: We performed a retrospective multi-center cohort study in which we compared 3 body mass index groups (normal, overweight and obese groups) in patients with heart failure with reduced ejection fraction receiving sacubitril/valsartan. The follow-up period was at least 1 year. Propensity score weighting was performed. The primary outcomes were hospitalization for heart failure and all-cause mortality. Results: Of the 721 patients in the original cohort, propensity score weighting generated a cohort of 540 patients in 3 groups: normal weight (n = 78), overweight (n = 181), and obese (n = 281). All baseline characteristics were well-balanced between 3 groups after propensity score weighting. Among our results, we found no significant differences in hospitalization for heart failure (normal weight versus overweight: average hazard ratio [AHR] 1.29, 95% confidence interval [CI] = 0.76-2.20, P = 0.35; normal weight versus obese: AHR 1.04, 95% CI = 0.63-1.70, P = 0.88; overweight versus obese groups: AHR 0.81, 95% CI = 0.54-1.20, P = 0.29) or all-cause mortality (normal weight versus overweight: AHR 0.99, 95% CI = 0.59-1.67, P = 0.97; normal weight versus obese: AHR 0.87, 95% CI = 0.53-1.42, P = 0.57; overweight versus obese: AHR 0.87, 95% CI = 0.58-1.32, P = 0.52). Conclusion: We identified no significant associations between BMI and clinical outcomes in patients diagnosed with heart failure with a reduced ejection fraction who were treated with sacubitril/valsartan. A large-scale study should be performed to verify these results.

Download Full-text

Body Habitus and Prognosis in Patients With Heart Failure After Acute Decompensation. A Comparison of Survival According to Body-Mass Index

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2010.07.218 ◽

2010 ◽

Vol 16 (9) ◽

pp. S172

Author(s):

Aya Banno ◽

Shun Kohsaka ◽

Kazuki Ohshima ◽

Yutaka Endo ◽

Masashi Takahashi ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Body Mass ◽

Body Habitus ◽

Patients With Heart Failure ◽

Acute Decompensation

Download Full-text

The relationship between body mass index/body composition and survival in patients with heart failure

Journal of the American Academy of Nurse Practitioners ◽

10.1111/j.1745-7599.2008.00328.x ◽

2008 ◽

Vol 20 (6) ◽

pp. 326-332 ◽

Cited By ~ 12

Author(s):

Shelby Shirley ◽

Leslie L. Davis ◽

Barbara Waag Carlson

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Body Composition ◽

Body Mass ◽

Patients With Heart Failure ◽

The Relationship

Download Full-text

Does Body Mass Index Influence Mortality in Patients With Heart Failure?

Revista Española de Cardiología (English Edition) ◽

10.1016/s1885-5857(08)60042-0 ◽

2007 ◽

Vol 60 (11) ◽

pp. 1127-1134 ◽

Cited By ~ 1

Author(s):

Elisabet Zamora ◽

Josep Lupón ◽

Agustín Urrutia ◽

Beatriz González ◽

Dolores Mas ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Body Mass ◽

Patients With Heart Failure

Download Full-text

Predicting the risk of sarcopenia in elderly patients with patellar fracture: Development and assessment of a new predictive nomogram

10.1101/702548 ◽

2019 ◽

Author(s):

Chen Yisheng ◽

Tao Jie

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Elderly Patients ◽

Prediction Model ◽

Predictive Model ◽

Body Mass ◽

Curve Analysis ◽

Decision Curve Analysis ◽

Low Body Mass Index ◽

Patellar Fractures

AbstractPurposeThis study was aimed at developing a risk prediction model for postoperative dysplasia in elderly patients with patellar fractures in China.Patients and methodsWe conducted a community survey of patients aged ≥55 years who underwent surgery for patellar fractures between January 2013 and October 2018, through telephone interviews, community visits, and outpatient follow-up. We established a predictive model for assessing the risk of sarcopenia after patellar fractures. We developed the prediction model by combining multivariate logistic regression analysis with the least absolute shrinkage model and selection operator regression (Lasso analysis). The predictive quality and clinical utility of the predictive model were determined using C-index, calibration plots, and decision curve analysis. We conducted internal sampling methods for qualitative assessment.ResultWe recruited 61 participants (males: 20, mean age: 68.1 years). Various risk factors were assessed, and low body mass index and diabetes mellitus were identified as the most important risk factors (P<0.05). The model showed a good prediction rate (C-index: 0.909; 95% confidence interval: 0.81–1.00) and good correction effect. The C-index remained high (0.828) even after internal sample verification. Decision curve analysis showed that the risk of sarcopenia was 8.3–80.0%, suggesting good clinical practicability.ConclusionOur prediction model shows promise as a cost-effective tool for predicting the risk of postoperative sarcopenia in elderly patients based on the following: advanced age, low body mass index, diabetes, longer postoperative hospital stay, no higher education, no postoperative rehabilitation, removal of internal fixation, and less outdoor exercise.

Download Full-text