AUTHOR=Salvino Nathália Felix Araujo , Sousa Lyz Tavares de , Abrahao Fabio Maia , Spineti Pedro Pimenta de Mello , Sales Ana Luiza Ferreira , Neves de Albuquerque Felipe , Bittencourt Marcelo Imbroinise , de Moraes Pedro Castello Branco , Esporcatte Roberto , Mourilhe-Rocha Ricardo TITLE=Is the obesity paradox in outpatients with heart failure reduced ejection fraction real? JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=10 YEAR=2023 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1239722 DOI=10.3389/fcvm.2023.1239722 ISSN=2297-055X ABSTRACT=Background

The obesity occurrence has achieved epidemic levels worldwide and several studies indicate a paradoxical similarity among obesity and the prognosis in heart failure (HF). The primary objective was to understand the association between body mass index (BMI) and heart failure with reduced ejection fraction (HFREF) of ischemic etiology in outpatients, using mortality as a parameter. The secondary objectives were to determine the differences in HF functional class, pharmacological therapy and evaluate the prognostic value of MAGGIC Score in this population.

Methods

We analyzed 1,556 medical records from the HF outpatient clinic of a quaternary hospital and 242 were selected according to the criteria. Most were male, average age 62.6 (56–70), BMI 18.5–24.9 = 35.1%, 25–29.9 = 37.2%, 30–34.9 = 17.8%, 35–39.9 = 7%; BMI <18.5 and >40 groups were eliminated from the central analyzes because of scarce testing.

Results

BMI 30–34.9 and BMI 18.5–24.9 had the best prognosis, BMI 25–29.9 had an average performance, and BMI –39.9 group provided the worst outcome (p = 0.123). In the subcategory analysis, BMI 30–34.9 group had a better prognosis compared to the BMI 35–39.9 group (p = 0.033). In the multivariate analysis The MAGGIC score was not able to foretell mortality in this population according to BMI.

Conclusion

In not hospitalized patients with HFREF of ischemic etiology, obesity was not a protective factor.