DALLAS — Bigger is better for patients with heart failure, Dr. Stefan D. Anker said at the annual scientific sessions of the American Heart Association.
Increased weight was associated with a lower risk of death or hospitalization during nearly 5 years of follow-up in a post hoc analysis of more than 2,500 patients with heart failure.
The finding was consistent with previous reports that showed lower survival rates in heart failure patients who had a relatively low body mass index (BMI), said Dr. Anker, a cardiologist at the National Heart and Lung Institute in London.
“Never tell a patient with a BMI of less than 40 kg/m
The analysis used data collected in the Carvedilol or Metoprolol European Trial (COMET), which was designed to compare the efficacy of these two β-blockers in patients with moderate-to-severe heart failure (Lancet 2003;362:7–13). The study enrolled patients with New York Heart Association class II-IV disease and a left ventricular ejection fraction of less than 40%. Of the 3,029 patients in the study, Dr. Anker focused his analysis on 86% of patients who did not have edema at baseline. In addition to being treated with one of the two β-blockers, patients received a full panel of medications for heart failure. They were followed for an average of 58 months.
Mortality among 302 patients whose average BMI was less than 22 during the study was 49%, compared with a rate of 32% in 1,145 patients with BMI averages of 25–29.9 and a rate of 25% in 474 patients with averages of 30 or more during the study.
For every increased unit of BMI, mortality fell by 6%, and the rate of death or hospitalization for heart failure dropped by 2%. Both of these rate reductions were statistically significant, Dr. Anker said.
