The health outcomes of inflammation and obesity in patients with heart failure.

Saleh, ZT; Lennie, TA; Darawad, M; Alduraidi, H; Elshatarat, RA; Almansour, IM; Moser, DK

The health outcomes of inflammation and obesity in patients with heart failure.

Saleh, ZT Lennie, TA Darawad, M Alduraidi, H Elshatarat, RA Almansour, IM Moser, DK

Permalink

Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Heart & lung : the journal of critical care, 2020, 49, (6), pp. 896-901
Issue Date:: 2020-11

Closed Access

	Filename	Description	Size
	1-s2.0-S0147956320301643-main.pdf		735.21 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Saleh, ZT
dc.contributor.author	Lennie, TA
dc.contributor.author	Darawad, M
dc.contributor.author	Alduraidi, H
dc.contributor.author	Elshatarat, RA
dc.contributor.author	Almansour, IM
dc.contributor.author	Moser, DK
dc.date.accessioned	2021-04-09T03:52:03Z
dc.date.available	2020-05-06
dc.date.available	2021-04-09T03:52:03Z
dc.date.issued	2020-11
dc.identifier.citation	Heart & lung : the journal of critical care, 2020, 49, (6), pp. 896-901
dc.identifier.issn	0147-9563
dc.identifier.issn	1527-3288
dc.identifier.uri	http://hdl.handle.net/10453/147943
dc.description.abstract	<h4>Background</h4>Although obesity is a risk factor for cardiovascular disease, higher body mass index is related to longer event-free survival in patients with heart failure (HF). While previous research demonstrated that higher levels of inflammatory mediators were associated with shorter event-free survival, the effect of inflammation on the association between obesity and outcomes of HF have not been considered.<h4>Hypothesis</h4>Based on the obesity paradox, we hypothesized that patients with higher baseline body mass index (BMI) would experience better event-free survival than those with lower BMI regardless of inflammatory status.<h4>Method</h4>A sample of 415 patients with HF (age 61 ± 11.5 years; 31% female) provided blood to measure soluble tumor necrosis factor receptor1 (sTNFR1), a biomarker of inflammation. Patients were divided into 4 groups based on BMI and a median split of sTNFR1 levels: (1) high BMI ≥ 30 and sTNFR1 > 1804 pg/ml, (2) high BMI ≥ 30 and low sTNFR1 ≤ 1804 pg/ml, and (3) low BMI < 30 and high sTNFR1 > 1804 pg/ml vs. (4) low BMI < 30 and sTNFR1 ≤ 1804 pg/ml. Patients were followed for an average of 365 days to determine the time to first event of either all-cause hospitalization or death.<h4>Results</h4>There were 177 patients (43%) who experienced either an all-cause hospitalization or death. In a Cox regression, high BMI and high sTNFR1 category predicted time to event (hazard ratio = 1.7, 95% confidence interval = 1.01-2.9) with age, gender, race, left ventricular ejection fraction, New York Heart Association functional class (I/II versus III/IV), log-transformed N-terminal Pro-B-type natriuretic peptide levels, prescribed statin (yes/no), and comorbidity as covariates.<h4>Conclusion</h4>Being in a higher inflammation group was associated with shorter event-free survival regardless of BMI. This study provides evidence that inflammation is an important consideration in the association between obesity and better outcomes in patients with HF.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation	National Institute of Nursing ResearchP20NR010679
dc.relation.ispartof	Heart & lung : the journal of critical care
dc.relation.isbasedon	10.1016/j.hrtlng.2020.05.010
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1110 Nursing
dc.subject.classification	Nursing
dc.subject.mesh	Aged
dc.subject.mesh	Body Mass Index
dc.subject.mesh	Female
dc.subject.mesh	Heart Failure
dc.subject.mesh	Humans
dc.subject.mesh	Inflammation
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Obesity
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Prognosis
dc.subject.mesh	Stroke Volume
dc.subject.mesh	Ventricular Function, Left
dc.subject.mesh	Humans
dc.subject.mesh	Obesity
dc.subject.mesh	Inflammation
dc.subject.mesh	Stroke Volume
dc.subject.mesh	Body Mass Index
dc.subject.mesh	Prognosis
dc.subject.mesh	Ventricular Function, Left
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Heart Failure
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Aged
dc.subject.mesh	Body Mass Index
dc.subject.mesh	Female
dc.subject.mesh	Heart Failure
dc.subject.mesh	Humans
dc.subject.mesh	Inflammation
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Obesity
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Prognosis
dc.subject.mesh	Stroke Volume
dc.subject.mesh	Ventricular Function, Left
dc.title	The health outcomes of inflammation and obesity in patients with heart failure.
dc.type	Journal Article
utslib.citation.volume	49
utslib.location.activity	United States
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2021-04-09T03:52:02Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	49
utslib.citation.issue	6

Abstract:

Background

Although obesity is a risk factor for cardiovascular disease, higher body mass index is related to longer event-free survival in patients with heart failure (HF). While previous research demonstrated that higher levels of inflammatory mediators were associated with shorter event-free survival, the effect of inflammation on the association between obesity and outcomes of HF have not been considered.

Hypothesis

Based on the obesity paradox, we hypothesized that patients with higher baseline body mass index (BMI) would experience better event-free survival than those with lower BMI regardless of inflammatory status.

Method

A sample of 415 patients with HF (age 61 ± 11.5 years; 31% female) provided blood to measure soluble tumor necrosis factor receptor1 (sTNFR1), a biomarker of inflammation. Patients were divided into 4 groups based on BMI and a median split of sTNFR1 levels: (1) high BMI ≥ 30 and sTNFR1 > 1804 pg/ml, (2) high BMI ≥ 30 and low sTNFR1 ≤ 1804 pg/ml, and (3) low BMI < 30 and high sTNFR1 > 1804 pg/ml vs. (4) low BMI < 30 and sTNFR1 ≤ 1804 pg/ml. Patients were followed for an average of 365 days to determine the time to first event of either all-cause hospitalization or death.

Results

There were 177 patients (43%) who experienced either an all-cause hospitalization or death. In a Cox regression, high BMI and high sTNFR1 category predicted time to event (hazard ratio = 1.7, 95% confidence interval = 1.01-2.9) with age, gender, race, left ventricular ejection fraction, New York Heart Association functional class (I/II versus III/IV), log-transformed N-terminal Pro-B-type natriuretic peptide levels, prescribed statin (yes/no), and comorbidity as covariates.

Conclusion

Being in a higher inflammation group was associated with shorter event-free survival regardless of BMI. This study provides evidence that inflammation is an important consideration in the association between obesity and better outcomes in patients with HF.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/147943