Author + information
- Received September 27, 2017
- Accepted September 28, 2017
- Published online November 27, 2017.
- Tetsuro Tsujimoto, MD, PhD∗ ( and )
- Hiroshi Kajio, MD, PhD
- Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
- ↵∗Address for correspondence:
Dr. Tetsuro Tsujimoto, Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
Background There is a lack of studies that evaluate the association between abdominal obesity and subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF).
Objectives The present study aimed to assess the association between abdominal obesity and risk of all-cause mortality in patients with HFpEF.
Methods The present study used data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. The primary outcome was all-cause mortality. We analyzed and compared the hazard ratios (HRs) in patients with abdominal obesity and those without abdominal obesity using multivariable Cox proportional hazard models. Abdominal obesity was defined as a waist circumference of ≥102 cm in men and ≥88 cm in women.
Results The present study included 3,310 patients with HFpEF: 2,413 patients with abdominal obesity and 897 without abdominal obesity. The mean follow-up was 3.4 ± 1.7 years. During follow-up, 500 patients died. All-cause mortality rates in patients with and without abdominal obesity were 46.1 and 40.7 events per 1,000 person-years, respectively. After multivariable adjustment, the risk of all-cause mortality was significantly higher in patients with abdominal obesity than in those without abdominal obesity (adjusted HR: 1.52; 95% confidence interval [CI]: 1.16 to 1.99; p = 0.002). The risk of cardiovascular and noncardiovascular mortality was also significantly higher in patients with abdominal obesity than in those without abdominal obesity (adjusted HR: 1.50; 95% CI: 1.08 to 2.08; p = 0.01 and adjusted HR: 1.58; 95% CI: 1.00 to 2.51; p = 0.04, respectively).
Conclusions The risk of all-cause mortality was significantly higher in patients with HFpEF with abdominal obesity than in those without abdominal obesity.
- abdominal obesity
- all-cause mortality
- heart failure with preserved ejection fraction
- TOPCAT trial
The study was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (Grant Number: 26860701).
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 27, 2017.
- Accepted September 28, 2017.
- 2017 American College of Cardiology Foundation
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