title: Association of implantable defibrillator therapy risk with body mass index in systolic heart failure.
abstract: OBJECTIVE
  To determine whether risk for implantable cardioverter-defibrillator (ICD) therapy varies by body mass index (BMI) in systolic heart failure (HF).
  
  
  BACKGROUND
  It is unknown whether obesity increases sudden death risk in patients with systolic HF.
  
  
  METHODS
  Secondary analysis of patients with HF, left ventricular ejection fraction ≤0.40 and ICD (N = 464) was performed using Cox regression modeling to assess risk for first delivered ICD therapy, with patients grouped by BMI (kg/m(2)): normal (18.5 to <25), overweight (25 to <30), and obese (≥30).
  
  
  RESULTS
  Overweight patients, compared with patients with normal BMI, had greater adjusted risk for first ICD therapy (HR 1.66; 95% CI 1.02-2.71; P = 0.04), whereas obese BMI was not associated with risk for first ICD therapy.
  
  
  CONCLUSIONS
  There was an inverted U-shaped relationship between BMI and risk for first ICD therapy among systolic HF patients, with highest risk in overweight BMI.
authors.affiliation: Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI 48109-5853, USA.
authors.forename: Mitul
authors.initials: M
authors.lastname: Gandhi
authors.forename: Todd M
authors.initials: TM
authors.lastname: Koelling
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.forename: Shaun P
authors.initials: SP
authors.lastname: Patel
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Wojcik
authors.forename: Laura E
authors.initials: LE
authors.lastname: Horwood
authors.forename: Audrey H
authors.initials: AH
authors.lastname: Wu
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016757:Death, Sudden, Cardiac / Q000209:etiology; D017147:Defibrillators, Implantable; D005260:Female; D054143:Heart Failure, Systolic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications*; D016016:Proportional Hazards Models; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications
keywords: ACE; ARB; BMI; Body mass index; HF; Heart failure; ICD; Implantable cardioverter-defibrillator; Risk stratification; UMHS; University of Michigan Health System; VAD; aldosterone receptor blocker; angiotensin converting enzyme; body mass index; heart failure; implantable cardioverter-defibrillator; ventricular assist device