Prediction of all-cause and cardiovascular mortality with weight loss in patients with chronic heart failure: a meta-analysis

Fan, Yu; Gu, Xuyu; Zou, Chen

doi:10.1177/2047487319871122

Cited by 11 publications

(5 citation statements)

References 9 publications

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“…Unlike with all-cause mortality, however, we found that UWL was not an independent predictor of CVD mortality. In accordance with the current findings, previous studies found significant associations between UWL and mortality from all causes [32] but not between UWL and morbidity or mortality from CVD [7,33]. Contrasting findings regarding the association between UWL and CVD mortality might stem from presence or absence of existing health conditions [7], sex or ethnicity differences [2], and others [29,31].…”

Section: Discussionsupporting

confidence: 87%

Unintentional weight loss as a predictor of all-cause and cardiovascular disease mortality in older Korean men

2021

JOMH

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Background and objective: Little is known regarding the prognostic role of unintentional weight loss (UWL) in mortality risk among older Korean men. This study examined the associations of UWL and unhealthy behaviors with all-cause and cardiovascular disease (CVD) mortality in Korean men aged 60 years and older. Material and Methods: Data (n = 2,309) obtained from the Korean longitudinal study of aging were analyzed. Exposures were UWL, smoking, alcohol abuse, underweight/obesity, and physical inactivity. Primary outcomes were all-cause mortality and CVD mortality. Covariates included parameters of sociodemographics and health conditions. Results: Individuals with three or more risk factors had signiﬁcantly higher risks of all-cause mortality (hazard ratio [HR] = 1.536, 95% conﬁdence interval [CI] = 1.084∼2.175, P = 0.016) and CVD mortality (HR = 2.925, 95% CI = 1.386∼6.174, P = 0.005) even after adjustments for parameters of sociodemographics, health conditions, and UWL compared to individuals with zero risk factors (HR = 1). Additionally, individuals with UWL had a signiﬁcantly higher risk of all-cause mortality (HR = 1.307, 95% CI = 1.052∼1.623, P = 0.016) even after adjustments for the covariates and lifestyle risk factors compared to individuals with normal weight (HR = 1). Conclusion: The current ﬁndings show that exposure to three or more lifestyle risk factors is an independent predictor of all-cause mortality and CVD mortality, and UWL was a predictor of all-cause mortality in older Korean men.

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Section: Discussionsupporting

confidence: 87%

Unintentional weight loss as a predictor of all-cause and cardiovascular disease mortality in older Korean men

2021

JOMH

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“…Current HF guidelines define a >5% oedema-free body weight loss during the previous 12 months or less as the key feature of cardiac cachexia, which is associated with a poor prognosis [2]. According to a recent meta-analysis of eight studies including 226,506 patients with chronic HF, weight loss >5% is associated with a 74% higher mortality risk as compared to stable weight [113]. Then again, weight loss has been shown to reduce the incidence of HF [114].…”

Section: Resultsmentioning

confidence: 99%

The Obesity Paradox in Heart Failure: Is It Still Valid in Light of New Therapies?

et al. 2022

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Background: Obesity increases the risk of cardiovascular disease and heart failure (HF). However, in patients with established HF, many studies observed greater survival with increasing adiposity. This counterintuitive observation has been termed the “obesity paradox”. In recent years, new HF therapies have emerged that improve prognosis in patients with HF. Some of these, such as sodium-glucose cotransporter 2 inhibitors (SGLT2i), cause weight loss and may therefore interfere with the obesity paradox. Summary: This article is a narrative review on the relationship between body weight and outcomes in patients with HF with special focus on new HF treatments. PubMed was searched for studies reporting the prognostic impact of obesity in HF from 2002 to February 22nd 2022. More than 400 records were examined, with 150 being included in the present review. Literature provides evidence for an obesity paradox in a broad range of HF patients, including acute and chronic HF across the spectrum of left ventricular ejection fraction. It has been verified in HF patients treated with SGLT2i but not in those using sacubitril/valsartan. Cardiorespiratory fitness and severity of HF seem to be important confounders of the obesity paradox in HF. While unintentional weight loss is associated with a poor prognosis in HF, weight loss associated with SGLT2i treatment appears safe. Key messages: Consensus has yet to emerge as to whether the obesity paradox is a true phenomenon in HF. As cardiorespiratory fitness is strongly associated with prognosis and significantly modifies the relationship between adiposity and survival in HF, regular physical activity is recommended irrespective from body weight. In HF patients with severe obesity, a modest weight reduction of 5-10% may be reasonable to improve HF symptoms and quality of life.

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“…A previous meta-analysis showed that WL was independently linked to increasing all-cause mortality risk for chronic HF individuals. 17 However, patients enrolled in previous studies were older than 60 years. Zamora et al 8 suggested an association between WL and greater long-term morbidity, especially in obese HF patients with an average age of 65.8 years.…”

Section: Discussionmentioning

confidence: 99%

Prognostic influence of weight loss on overweight/obese young heart failure patients

He,

Guan,

Zhang

2024

SMJ

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Objectives: To explore the prognostic influence of weight loss (WL) on young overweight/obesity (OW/OB) individuals with heart failure (HF). Methods: Heart failure enrollees (younger than 45 years, body mass index [BMI] of ≥25 kg/m 2 ) who received medical treatment at Beijing Chaoyang Hospital, Beijing, China, were classified into 2 groups according to whether they experienced significant WL (≥5% from baseline one year after discharge). One-year occurrence rate of major adverse cardiac events (MACEs) comprising cardiac death and rehospitalization for HF was determined. Results: Of the 191 individuals recruited for this study, 47 had significant WL. The incidence of ischemic heart disease and obstructive sleep apnea syndrome, as well as BMI and blood pressure, were higher in those with significant WL compared to the control group. Although there was no noteworthy discrepancy in the occurrence of cardiac death between the 2 groups, significant WL correlated independently with a lower incidence of HF re-hospitalization (hazard ratio [HR]=0.32, 95% confidence interval [CI]: [0.11-0.91], p =0.032) and overall MACEs (HR=0.37, 95% CI: [0.14-0.94], p =0.036) in young OW/OB individuals with HF. Conclusion: Significant WL may correlate with favorable prognosis in OW/OB young HF patients.

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Prediction of all-cause and cardiovascular mortality with weight loss in patients with chronic heart failure: a meta-analysis

Cited by 11 publications

References 9 publications

Unintentional weight loss as a predictor of all-cause and cardiovascular disease mortality in older Korean men

Unintentional weight loss as a predictor of all-cause and cardiovascular disease mortality in older Korean men

The Obesity Paradox in Heart Failure: Is It Still Valid in Light of New Therapies?

Prognostic influence of weight loss on overweight/obese young heart failure patients

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