title: Malnutrition syndrome, but not body mass index, is associated to worse prognosis in heart failure patients.
abstract: OBJECTIVE
  Many studies have suggested that obese patients with chronic heart failure have a better prognosis than leaner patients. The main purpose of this study was to assess the prognostic value of body mass index in patients with chronic heart failure, independently of other poor prognosis parameters.
  
  
  METHODS
  This retrospective study included 405 heart failure patients. Anthropometric, body composition, clinical, biochemical, and echocardiographic data were collected from all patients. Patients were classified as: underweight (<20 kg/m(2)), normal (20-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)). The endpoints were all-cause and cardiovascular mortality.
  
  
  RESULTS
  Cox regression analysis on all-cause mortality showed that normal weight patients were at significantly lower risk of death [RR = 0.231 (CI(95%) 0.085-0.627)] as compared with obese patients, while underweight and overweight categories did not show a significantly different risk compared with the reference category. Age, gender, ejection fraction, systolic heart failure, angiotensin II receptor blockers use, hemoglobin levels, and handgrip strength were independent predictors of all-cause mortality. Cardiovascular deaths showed the same trend.
  
  
  CONCLUSIONS
  A lower body mass index does not predict all-cause and cardiovascular mortality among chronic heart failure patients, independently of other nutritional, body composition, and clinical status parameters.
authors.affiliation: Heart Failure Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City 14000, Mexico. eloisa_colin@yahoo.com.mx
authors.forename: Eloisa
authors.initials: E
authors.lastname: Colín-Ramírez
authors.forename: Arturo
authors.initials: A
authors.lastname: Orea-Tejeda
authors.forename: Lilia
authors.initials: L
authors.lastname: Castillo-Martínez
authors.forename: Patricia
authors.initials: P
authors.lastname: Montaño-Hernández
authors.forename: Anahí
authors.initials: A
authors.lastname: Sánchez-Ramírez
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Pineda-Juárez
authors.forename: Verónica
authors.initials: V
authors.lastname: Rebollar-González
mesh_terms: D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D017097:Electric Impedance; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006333:Heart Failure / Q000150:complications* / Q000401:mortality; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000401:mortality; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins