title: A U-shaped association of body mass index and all-cause mortality in heart failure patients: A dose-response meta-analysis of prospective cohort studies.
abstract: OBJECTIVE
  The role of body mass index (BMI) for the prognosis of heart failure (HF) patients remains to be a great interest for a long time. However, the precise effect of dose-response for BMI and mortality risk in patients with HF is still unclear. We conducted a dose-response meta-analysis to quantitatively assess the effect of BMI on all-cause mortality in subjects with HF.
  
  
  METHODS
  Fourteen prospective cohort studies included 13 508 death cases identified among 46 794 patients with HF.
  
  
  RESULTS
  The summary HR per 5 units increase in BMI was 0.95 (95% CI=0.92-0.97) with evidence of high heterogeneity (I2=90.10%, Pheterogeneity<.00001), and an U-shaped nonlinear relationship of BMI and risk of mortality from all-causes was revealed (Pnonlinearity=.0025). When stratified analyses were conducted, the heterogeneity in patients with HF aged more than 60 years decreased.
  
  
  CONCLUSIONS
  Heart failure patients with higher BMI (>28 kg/m2) have a better survival, whereas underweight and those with severe obesity (eg, BMI>37 kg/m2) have a higher mortality.
authors: Department of Cardiovascular Medicine, The Central Hospital of Fuling, Chongqing University, Fuling, China.
authors: Wei
authors: W
authors: Qin
authors: Department of Cardiovascular Medicine, The Third Military Medical University Southwest Hospital, Chongqing, China.
authors: Feng
authors: F
authors: Liu
authors: Department of Cardiovascular Medicine, The Third Military Medical University Southwest Hospital, Chongqing, China.
authors: Chen
authors: C
authors: Wan
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000401:mortality*; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013851:Thinness / Q000175:diagnosis / Q000401:mortality*; D013997:Time Factors
keywords: All-cause mortality; Body mass index; Dose-response; Heart failure survivors; Meta-analysis