Obese Patients and Acute Systolic Heart Failure, Latest Findings

Author(s):

Research has consistently identified obesity as a major risk factor for cardiovascular disease. Investigators have also reported on the obesity paradox concept suggesting improved prognosis in patients with obesity presenting with acute coronary syndromes.

Time and time again research has identified obesity as a major risk factor for cardiovascular disease (CVD).

Taking it a step further, investigators have reported on the obesity paradox concept suggesting improved prognosis in patients with obesity presenting with acute coronary syndromes.

Saturday, March 14, at the 2015 American College of Cardiology annual meeting, Gauravkumar Patel, MD, will present the impact of obesity on in-hospital mortality in patients presenting acute systolic heart failure.

Patel and his colleagues used the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS), the largest publicly available inpatient database designed to provide information on characteristics and outcomes of patients discharged from United States community hospitals.

The NIS allowed them to identify 136,999 adult patients presenting with acute systolic heart failure between the years 2008 to 2010. Among the dataset, 16,461 had a diagnosis of obesity.

The team observed that the obese patients were generally younger (61 yrs. vs. 72 yrs. p<0.001) and slightly more likely to be females (42% vs. 40%, p<0.001) compared to the non-obese group. Additionally, they were found to have a higher frequency of hypertension (44% vs. 36%, p<0.001) and diabetes mellitus (60% vs. 39%, p<0.001), but a lower frequency of atrial fibrillation (31.4 % vs. 35.1%, p<0.001) and CKD (36% vs. 41%, p < 0.001).

It was important to note that obese patients were slightly less likely to have an ischemic heart disease (15% vs. 16%, p < 0.001). The in-hospital mortality rate for patients with systolic heart failure and obesity was 1.6%, compared to 3.0% in patients without obesity, and after adjusting for relevant covariates, obesity still remained an independent predictor of lower in-hospital mortality.

In turn, Patel commented that these findings supported the team's initial hypothesis that obesity is, in fact, associated with lower in-hospital mortality in patients presenting with systolic heart failure.