A reduction of BMI predicts the risk of rehospitalization and cardiac death in non-obese patients with heart failure.

BACKGROUND

Low body mass index (BMI) has been associated with decreased survival in patients with heart failure (HF), although Obesity is an important risk factor for cardiovascular disease. HF patients with a relatively higher BMI tend to live longer, which is known as "Obesity Paradox". However, cardiac cachexia is another determinant of prognosis in HF patients. This study investigated whether a change in BMI is associated with either prognosis or frequency of hospitalizations in patients with HF.

METHODS

We correlated changes in BMI to prognosis and frequency of hospitalizations in patients who were hospitalized for decompensated HF. A total of 971 HF patients were initially evaluated, and 81 patients with repeat HF admissions were included.

RESULTS

The average change in BMI was -0.05 ± 0.15, -0.87 ± 0.56, -1.03 ± 0.34, and -1.97 ± 0.33 in patients who were hospitalized twice, three times, four times, and over five times, respectively. The reduction in BMI correlated with the frequency of hospitalizations (P < 0.01). We compared patients with increased BMI (group I, n = 38) versus decreased BMI (group D, n = 43) between the first and second discharge. The rate of hospitalization in group D was higher than in group I, and group D had a lower survival rate. The reduction of BMI was a significant and independent risk factor for cardiac death (HR, 4.17; 95% CI, 1.53 to 14.6).

CONCLUSIONS

Losing body weight in HF patients was a significant predictive factor of the frequency of hospitalizations and increased mortality.