Impact of overweight on survival and primary graft failure after heart transplantation.
BACKGROUND
Overweight influence on prognosis after heart transplantation remains controversial. The objective of this study was to determine the relationship between overweight and survival in this setting.


METHODS
We evaluated 271 cardiac transplant recipients engrafted from 1991 to 2009 whose age was 50.3±12.1 (mean; SD) years. Their body mass index (BMI) was 25.7±3.9 kg/m2. Regarding gender, 85.2% were males. Patients were classified by pretransplantation BMI into group A (>25 kg/m2) and group B (<25 kg/m2). We analyzed the differences in mortality and related factors.


RESULTS
One hundred fifty Group A patients (55.4%) showed a slightly lower median survival (7.35 vs 8.62 years; P=.152). Group A patients were at higher risk of death within 1 year of follow-up (HR, 1.71; confidence interval [CI], 0.996-2.939; P=.051). Overweight was associated with increased mortality at 1 year after adjustment for age, recipient gender, hypertension, diabetes mellitus, hypercholesterolemia, coronary artery disease, and donor-recipient heart size mismatch. The incidence of primary graft failure was also significantly increased in group A (HR, 2.74; CI, 1.17-6.40; P=.017) after adjustment for the same variables. There were no significant differences between the groups concerning surgical ischemic time, number of acute rejection episodes, and infections during the first year.


CONCLUSIONS
In our sample, overweight was associated with increased mortality and an increased incidence of primary graft failure within 1 year after cardiac transplantation.
Guisado Rasco
A
A
Department of Cardiology, University Hospital Virgen del Rocío, Seville, Spain. aguiras@hotmail.com
Sobrino Márquez
J M
JM
Nevado Portero
J
J
Romero Rodríguez
N
N
Ballesteros Prada
S
S
Lage Gallé
E
E
Martínez Martínez
A
A
D000328:Adult; D015992:Body Mass Index; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight; D016019:Survival Analysis