Heart failure & cardiomyopathies

Obesity in heart failure with preserved ejection fraction with and without diabetes: risk factor or innocent bystander?

Eur J Prev CardiolPublished Cohort study

Main finding · All-cause death by BMI category (overall cohort, unadjusted)Result — go to the resultHazard ratio 1.27 CI 1.09–1.48

Authors' conclusion

Among the various phenotypes of HFpEF, the T2DM phenotype is specifically associated with a greater disease burden. Higher BMI is linked to improved survival in HFpEF overall, while this effect neutralises in patients with concomitant T2DM.

Study context

Population
Patients with heart failure with preserved ejection fraction (HFpEF) with and without T2DM, enrolled 2010–20201,702 (25%) with T2DM
Participants
6,744 patients
Exposure
Body mass index (BMI) categories, with vs without T2DM
Outcome
All-cause death
Follow-up
Median 47 months (Q1-Q3: 20-80)

Main finding

As reported in the abstract

All-cause death by BMI category (overall cohort, unadjusted)

Hazard ratio

1.27

CI 1.09–1.48

P = 0.003

BMI <22.5 kg/m²vs BMI 22.5-24.9 kg/m²
HR 1.27 (CI 1.09–1.48); P = 0.003

Observational data: associations, not effects.

Further findings

Mortality, T2DM vs non-T2DM · median follow-up 47 months

P < 0.001

OutcomeT2DMNon-T2DM
BMI and NT-proBNP, T2DM vs non-T2DM
BMI29.4 kg/m²27.1 kg/m²
NT-proBNP864 mg/dL724 mg/dL
  • Mortality, T2DM vs non-T2DM: 2014 (30%) patients died overall
  • BMI and NT-proBNP, T2DM vs non-T2DM: BMI P < 0.001
  • BMI and NT-proBNP, T2DM vs non-T2DM: NT-proBNP P < 0.001

Original publication

Obesity in heart failure with preserved ejection fraction with and without diabetes: risk factor or innocent bystander? Eur J Prev Cardiol. Published 21 May 2023. doi:10.1093/eurjpc/zwad140

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