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

Int J Cardiol. 2019 Feb 1;276:166-170. doi: 10.1016/j.ijcard.2018.08.054. Epub 2018 Aug 18.


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.

Keywords: Body mass index; Heart failure; Hospitalization.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Body Weight / physiology*
  • Death*
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Obesity*
  • Patient Readmission / trends*
  • Prognosis
  • Retrospective Studies
  • Risk Factors