• Eloisa Colín-Ramírez, Arturo Orea-Tejeda, Lilia Castillo-Martínez, Patricia Montaño-Hernández, Anahí Sánchez-Ramírez, Juan Antonio Pineda-Juárez, and Verónica Rebollar-González.
• Heart Failure Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City 14000, Mexico. eloisa_colin@yahoo.com.mx
• Clin Nutr. 2011 Dec 1; 30 (6): 753-8.

Background & AimsMany studies have suggested that obese patients with chronic heart failure have a better prognosis than leaner patients. The main purpose of this study was to assess the prognostic value of body mass index in patients with chronic heart failure, independently of other poor prognosis parameters.MethodsThis retrospective study included 405 heart failure patients. Anthropometric, body composition, clinical, biochemical, and echocardiographic data were collected from all patients. Patients were classified as: underweight (<20 kg/m(2)), normal (20-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)). The endpoints were all-cause and cardiovascular mortality.ResultsCox regression analysis on all-cause mortality showed that normal weight patients were at significantly lower risk of death [RR = 0.231 (CI(95%) 0.085-0.627)] as compared with obese patients, while underweight and overweight categories did not show a significantly different risk compared with the reference category. Age, gender, ejection fraction, systolic heart failure, angiotensin II receptor blockers use, hemoglobin levels, and handgrip strength were independent predictors of all-cause mortality. Cardiovascular deaths showed the same trend.ConclusionA lower body mass index does not predict all-cause and cardiovascular mortality among chronic heart failure patients, independently of other nutritional, body composition, and clinical status parameters.2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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