Obesity Is Associated with a Lower Risk of Mortality and Readmission in Heart Failure Patients with Diabetes.

Objectives

We aim to investigate the relationship between body weight and the risk of cardiovascular events in heart failure patients with diabetes.

Methods

We therefore conducted a retrospective analysis of HF patients with T2D using the Nationwide Readmissions Database (NRD) from 2016 to 2022. Patients were stratified by BMI classes: underweight, normal weight, overweight, and obesity classes I-III. The primary outcome was in-hospital mortality. Secondary outcomes included 1-year mortality and readmission for heart failure.

Results

A total of 26,199 patients with BMI data were included in the analysis. Underweight patients had the highest risk of in-hospital mortality [aOR = 1.80 (95% CI: 1.16-2.80)] and cardiogenic shock [aOR = 2.13 (95% CI: 1.26-3.59)]. In contrast, obesity classes I-III were associated with significantly lower odds of those events. One-year mortality rates did not differ significantly across BMI groups. However, obesity classes II and III were associated with a lower adjusted risk of HF readmission [aHR = 0.71 (95% CI: 0.50-0.99); aHR = 0.68 (95% CI: 0.49-0.96), respectively].

Conclusions

In patients with T2D and HF, an obesity paradox exists whereby patients with obesity have a lower risk of in-hospital mortality and cardiogenic shock. Further, obesity classes II-III are associated with a lower risk of 1-year readmission for HF.