Author + information
- Alessandra Chen,
- Tamara Horwich and
- Nolan Nardoni
Background: It seems that less fat would prolong survival in heart disease. However, in heart failure, obesity may protect against cardiovascular events or death — the obesity paradox. Our study aims to define how body composition contributes to survival in coronary heart disease (CHD).
Methods: We analyzed 558 CHD patients in Cardiac Rehabilitation from 2009-2015. We evaluated body fat % (BF), BF and weight change, lean body mass (LBM), lean mass index (LMI), BMI. BF, LBM were measured by Bioelectrical Impedance Analysis. LMI was calculated by LBM/height2. Kaplan Meier analysis for cardiovascular event/death or all-cause mortality was performed.
Results: Our cohort was 74.6% male, 25.4% female. 65.9% were alive, 31.9% had an event, 2.2% died. We found an association between BF reduction and a trend towards improved event-free survival (p=0.114) and all-cause mortality (p=0.090). Weight loss elicited a trend towards better event-free survival (p=0.058) and high LBM; a trend towards better all-cause mortality (p=0.031). Overweight BMI (25-29.9) possibly improved outcomes over normal weight BMI (≤24.9) or obese BMI (≥30). Baseline BF and LMI did not affect outcome. Analysis by gender did not produce significant differences.
Conclusions: Our data suggests, in contrast to the obesity paradox, that BF/weight decrease and LBM increase during cardiac rehab is associated with a trend towards improved outcomes. Further research is needed to investigate the potential effect of body composition on survival in CHD.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Predicting Outcomes in Cardiac Rehabiltation Patients
Abstract Category: 34. Prevention: Rehabilitation
Presentation Number: 1276-042
- 2017 American College of Cardiology Foundation