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• W1994475916 abstract "Background and Purpose: Prior studies have shown conflicting results with respect to the mortality risk attendant to obesity among patients with heart failure (HF). We sought to address this question among participants in the Digitalis Investigators Group (DIG) trial. Methods: Using the public-access version of the DIG trial database, we examined clinical characteristics and long-term survival among trial patients segregated by body mass index (BMI). First, patients were separated into 4 equal groups based on quartiles of BMI. Then, patients were separated into 4 physiologically relevant groups based on actual BMI: “Obese” (BMI > 30, N = 1960), “Overweight” (BMI 26-30, N = 3084), “Normal” (BMI 20-25, N = 2334) and “Underweight” (BMI<20, N = 409). Chi square tables, ANOVA, the Kaplan-Meier method and proportional hazards models were used to examine differences among the groups. Results: Among 7787 DIG patients, mean (±SD) BMI was 27.3±5.4. In the quartile analyses, higher BMI was associated with younger age, diabetes, hypertension, non-ischemic cause of HF, higher ejection fraction, and lower creatinine. Women and non-whites were disproportionately represented among the lowest and highest quartiles of BMI. Patients in the highest quartile of BMI were least likely to have rales, elevated JVP or a third heart sound but most likely to have edema or be treated with diuretics. They least often received open-label digitalis prior to study enrollment. Crude survival by BMI quartile is shown in Figure 1 . Overall mortality was 28% in the highest quartile of BMI and 40% in the lowest. In proportional hazards models, BMI quartile remained predictive of survival. Each 5 unit increase in BMI was associated with an 8% reduction in the risk of death (odds ratio, OR, 0.92; 95% confidence interval, CI, 0.88-0.96). Results for the physiological analyses were nearly identical to the quartile analyses, except that diuretic use and non-ischemic cause of HF were not higher among Obese patients. Crude survival by BMI group is shown in Figure 2 View Large Image Figure ViewerDownload (PPT). Overall mortality was 28% in the Obese group and 44% in the Underweight group. In proportional hazards models, BMI group remained predictive of survival. Relative to Obese patients, Normal patients (OR = 1.19, CI = 1.06-1.33) and Underweight patients (OR = 1.56, CI = 1.31-1.86) were at significantly higher risk of death. Conclusion: Higher BMI was associated with better survival in the DIG trial while lower BMI was associated with worse. This relationship persisted even after accounting for substantive differences among the groups." @default.
• W1994475916 created "2016-06-24" @default.
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• W1994475916 date "2003-10-01" @default.
• W1994475916 modified "2023-10-16" @default.
• W1994475916 title "The relationship between body mass index and survival in heart failure" @default.
• W1994475916 doi "https://doi.org/10.1016/s1071-9164(03)00236-7" @default.
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