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Long-Term Impact of Body Mass Index on Survival of Patients Undergoing Cardiac Resynchronization Therapy: A Multi-Centre Study

N. Papageorgiou, A. Briasoulis, S. Barra, C. Sohrabi, WY. Lim, S. Agarwal, E. Oikonomou, R. Duehmke, T. Roubicek, R. Polasek, JM. Behar, CA. Rinaldi, M. Neto, M. Goncalves, P. Adragao, D. Tousoulis, A. Creta, E. Rowland, S. Ahsan, RJ. Schilling,...

. 2021 ; 153 (-) : 79-85. [pub] 20210625

Language English Country United States

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc21025117
E-resources Online Full text

NLK ProQuest Central from 2012-08-15 to 2 months ago
Nursing & Allied Health Database (ProQuest) from 2012-08-15 to 2 months ago
Health & Medicine (ProQuest) from 2012-08-15 to 2 months ago

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PubMed 34183146
DOI 10.1016/j.amjcard.2021.05.024
Knihovny.cz E-resources

Obesity is a risk factor for heart failure (HF), but its presence among HF patients may be associated with favorable outcomes. We investigated the long-term outcomes across different body mass index (BMI) groups, after cardiac resynchronization therapy (CRT), and whether defibrillator back-up (CRT-D) confers survival benefit. One thousand two-hundred seventy-seven (1,277) consecutive patients (mean age: 67.0 ± 12.7 years, 44.1% women, and mean BMI: 28.3 ± 5.6 Kg/m2) who underwent CRT implantation in 5 centers between 2000-2014 were followed-up for a median period of 4.9 years (IQR 2.4 to 7.5). More than 10% of patients had follow-up for ≥10 years. Patients were classified according to BMI as normal: <25.0 Kg/m2, overweight: 25.0 to 29.9 Kg/m2 and obese: ≥30.0 Kg/m2. 364 patients had normal weight, 494 were overweight and 419 were obese. CRT-Ds were implanted in >75% of patients, but were used less frequently in obese individuals. The composite endpoint of all-cause mortality or cardiac transplant/left ventricular assist device (LVAD) occurred in 50.9% of patients. At 10-year follow-up, less than a quarter of patients in the lowest and highest BMI categories were still alive and free from heart transplant/LVAD. After adjustment BMI of 25 to 29.9 Kg/m2 (HR = 0.73 [95%CI 0.56 to 0.96], p = 0.023) and use of CRT-D (HR = 0.74 [95% CI 0.55 to 0.98], p = 0.039) were independent predictors of survival free from LVAD/heart transplant. BMI of 25 to 29.9 Kg/m2 at the time of implant was independently associated with favourable long-term 10-year survival. Use of CRT-D was associated with improved survival irrespective of BMI class.

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