A reduction of BMI predicts the risk of rehospitalization and cardiac death in non-obese patients with heart failure

Background: Low body mass index (BMI) has been associated with decreased survival in patients with heart failure (HF), although Obesity is an important risk factor for cardiovascular disease. HF patients with a relatively higher BMI tend to live longer, which is known as "Obesity Paradox". However, cardiac cachexia is another determinant of prognosis in HF patients. This study investigated whether a change in BMI is associated with either prognosis or frequency of hospitalizations in patients with HF. Methods: We correlated changes in BMI to prognosis and frequency of hospitalizations in patients who were hospitalized for decompensatecl HP. A total of 971 HF patients were initially evaluated, and 81 patients with repeat HF admissions were included. Results: The average change in BMI was 0.05 +/- 0.15, -0.87 +/- 0.56, 1.03 +/- 0.34, and 1.97 +/- 0.33 in patients who were hospitalized twice, three times, four times, and over five times, respectively. The reduction in BMI correlated with the frequency of hospitalizations (P < 0.01). We compared patients with increased BMI (group I, n 38) versus decreased BMI (group D, n 43) between the first and second discharge. The rate of hospitalization in group D was higher than in group I, and group D had a lower survival rate. The reduction of BMI was a significant and independent risk factor for cardiac death (HR, 4.17; 95% CI, 1.53 to 14.6). Conclusions: Losing body weight in HF patients was a significant predictive factor of the frequency of hospitalizations and increased mortality. (C) 2018 Elsevier B.V. All rights reserved.