Heart failure & cardiomyopathies
Body Mass Index, Frailty, and Outcomes in Heart Failure with Preserved Ejection Fraction
Authors' conclusion
BMI distribution and association between BMI and frailty risk were different between the two study populations. Frailty was associated with clinical adverse events and this association was consistent across different BMI categories in both studies.
Study context
- Population
- Patients with HFpEF in a US cohort (TOPCAT) and a Chinese cohort (HERO); mean age 72 ± 11 years
- Participants
- 1,715 vs 1,487
- Comparison
- Frailty vs no frailty, by body mass index (BMI) category, US vs Chinese cohort
- TOPCATn = 1,715
- HEROn = 1,487
- Primary endpoint
- Composite of:
- Heart failure (HF) hospitalization
- Aborted sudden death
- CV death
Methodological detailscohort comparison, multivariate restricted cubic spline logistic regression, Cox proportional hazards models
- Cohort comparison
- Multivariate restricted cubic spline logistic regression
- Cox proportional hazards models
Primary result
As reported in the abstract
Primary composite outcome, frailty vs no frailty
Frailty vs No frailtyHazard ratio (95% CI)
TOPCAT
1.84(1.46–2.32)
HERO
1.26(1.01–1.57)
Further findings
Mean BMI
Moderately to severely frail (frailty index > 0.3)
Female sex
BMI and frailty risk
- In TOPCAT, risk of frailty rose as BMI increased, but not in HERO
Frailty–outcome association by BMI category
- Association of frailty with clinical outcomes did not vary with BMI categories in the two studies
Original publication
Body Mass Index, Frailty, and Outcomes in Heart Failure with Preserved Ejection Fraction. ESC Heart Fail. Published 22 December 2023. doi:10.
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