Heart failure & cardiomyopathiesCohort study
Obesity in heart failure with preserved ejection fraction with and without diabetes: risk factor or innocent bystander?
- Cohort study
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/m² vs 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
| Outcome | Values | P value |
|---|---|---|
| Mortality, T2DM vs non-T2DM · median follow-up 47 months | T2DM 39.2% · Non-T2DM 26.7% | P < 0.001 |
| BMI and NT-proBNP, T2DM vs non-T2DM | T2DM BMI 29.4 kg/m² · NT-proBNP 864 mg/dL · Non-T2DM BMI 27.1 kg/m² · NT-proBNP 724 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
Summarised from the published abstract; every number is checked against it