title: Positive influence of being overweight/obese on long term survival in patients hospitalised due to acute heart failure.
abstract: BACKGROUND
  Obesity is clearly associated with increased morbidity and mortality rates. However, in patients with acute heart failure (AHF), an increased BMI could represent a protective marker. Studies evaluating the "obesity paradox" on a large cohort with long-term follow-up are lacking.
  
  
  METHODS
  Using the AHEAD database (a Czech multi-centre database of patients hospitalised due to AHF), 5057 patients were evaluated; patients with a BMI <18.5 kg/m2 were excluded. All-cause mortality was compared between groups with a BMI of 18.5-25 kg/m2 and with BMI >25 kg/m2. Data were adjusted by a propensity score for 11 parameters.
  
  
  RESULTS
  In the balanced groups, the difference in 30-day mortality was not significant. The long-term mortality of patients with normal weight was higher than for those who were overweight/obese (HR, 1.36; 95% CI, 1.26-1.48; p<0.001)). In the balanced dataset, the pattern was similar (1.22; 1.09-1.39; p<0.001). A similar result was found in the balanced dataset of a subgroup of patients with de novo AHF (1.30; 1.11-1.52; p = 0.001), but only a trend in a balanced dataset of patients with acute decompensated heart failure.
  
  
  CONCLUSIONS
  These data suggest significantly lower long-term mortality in overweight/obese patients with AHF. The results suggest that at present there is no evidence for weight reduction in overweight/obese patients with heart failure, and emphasize the importance of prevention of cardiac cachexia.
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Simona
authors.initials: S
authors.lastname: Littnerova
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Parenica
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
authors.affiliation: Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jirí
authors.initials: J
authors.lastname: Vitovec
authors.affiliation: 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
authors.affiliation: Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Miklik
authors.affiliation: Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
authors.affiliation: Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic.
authors.forename: Kamil
authors.initials: K
authors.lastname: Zeman
authors.affiliation: 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Belohlavek
authors.affiliation: Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Filip
authors.initials: F
authors.lastname: Malek
authors.affiliation: Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Felsoci
authors.affiliation: Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kettner
authors.affiliation: Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Ostadal
authors.affiliation: Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Cestmir
authors.initials: C
authors.lastname: Cihalik
authors.affiliation: Medical Faculty, Masaryk University, Brno, Czech Republic; 2nd Department of Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Spac
authors.affiliation: Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Al-Hiti
authors.affiliation: Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Fedorco
authors.affiliation: Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Richard
authors.initials: R
authors.lastname: Fojt
authors.affiliation: Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kruger
authors.affiliation: Department of Internal Medicine, Hospital Havlickuv Brod, Havlickuv Brod, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Malek
authors.affiliation: First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Tereza
authors.initials: T
authors.lastname: Mikusová
authors.affiliation: Department of Internal Medicine, Hospital Znojmo, Znojmo, Czech Republic.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Monhart
authors.affiliation: Department of Cardiology, T.Bata Hospital Zlin, Zlin, Czech Republic.
authors.forename: Stanislava
authors.initials: S
authors.lastname: Bohacova
authors.affiliation: Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic.
authors.forename: Lidka
authors.initials: L
authors.lastname: Pohludkova
authors.affiliation: Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Filip
authors.initials: F
authors.lastname: Rohac
authors.affiliation: Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Vaclavik
authors.affiliation: Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Vondrakova
authors.affiliation: First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic.
authors.forename: Klaudia
authors.initials: K
authors.lastname: Vyskocilova
authors.affiliation: Department of Cardiology, T.Bata Hospital Zlin, Zlin, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Bambuch
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
mesh_terms: D000208:Acute Disease; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000473:pathology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight; D016016:Proportional Hazards Models; D016019:Survival Analysis