Impact of weight loss in patients with heart failure with preserved ejection fraction: results from the FLAGSHIP study Article Swipe
Kenta Kamisaka
,
Kuniyasu Kamiya
,
Kotaro Iwatsu
,
Naoki Iritani
,
Shota Imoto
,
Takuji Adachi
,
Yuki Iida
,
Sumio Yamada
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1002/ehf2.13619
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1002/ehf2.13619
Aims Weight loss (WL) is a poor prognostic factor for patients with heart failure (HF) with reduced ejection fraction. However, its prognostic impact on patients with HF with preserved ejection fraction (HFpEF) remains unestablished. The evidence regarding the effects of obesity on the prognosis of WL is also unclear. We aimed to identify the risk factors for WL and examine the association between WL and prognosis of HFpEF in obese and non‐obese patients. Methods and results In this multicentre cohort study, the data of 573 patients hospitalized with HFpEF [median age: 78 years (interquartile range, 71–84 years); 49.2% female] were identified from hospital databases. WL was defined as ≥5% weight reduction within 6 months after discharge. Obesity was defined according to Japanese criteria as body mass index ≥25 kg/m 2 . The main study outcomes were all‐cause mortality and HF rehospitalization between 6 and 24 months after hospital discharge. Logistic regression analysis and Cox proportional hazards regression analysis were performed to identify independent the risk factors associated with WL and to calculate the hazard ratios (HRs) associated with adverse outcomes. The prevalence of obesity at discharge was 21.1%. At 6 month follow‐up, WL occurred in 17.4% and 10.8% of the obese and non‐obese patients, respectively. Onset of WL in non‐obese patients was associated with prior hospitalization for HF [odds ratio (OR) 2.39, 95% confidence interval (CI) 1.22–4.68, P = 0.011] and high levels of brain natriuretic peptide (OR 2.32, CI 1.17–4.60, P = 0.015). In obese patients, WL was associated with the use of mineralocorticoid receptor antagonists (OR 3.26, CI 1.08–9.76, P = 0.03) and vasopressin receptor antagonists (OR 6.61, CI 2.03–21.2, P = 0.001). During 1021.3 person‐years of follow‐up, 31 patients died, and upon 1081.0 person‐years follow‐up, 84 patients required rehospitalization for HF. In proportional hazards analysis, WL was associated with all‐cause mortality (HR 5.12, CI 2.08–12.5, P < 0.001) and HF rehospitalization (HR 2.63, CI 1.38–5.01, P = 0.003) after adjustment for confounders in non‐obese patients, but not in obese patients. Conclusions Weight loss should be considered as an indicator for monitoring worsening of HF condition in non‐obese patients with HFpEF. WL was not associated with adverse events in obese patients with HFpEF, possibly due to appropriate fluid management during follow‐up.
Related Topics
Concepts
Medicine
Hazard ratio
Interquartile range
Ejection fraction
Heart failure
Internal medicine
Proportional hazards model
Body mass index
Confidence interval
Heart failure with preserved ejection fraction
Obesity paradox
Cardiology
Odds ratio
Weight loss
Obesity
Natriuretic peptide
Overweight
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/ehf2.13619
- OA Status
- gold
- Cited By
- 21
- References
- 31
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3203343202
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3203343202Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1002/ehf2.13619Digital Object Identifier
- Title
-
Impact of weight loss in patients with heart failure with preserved ejection fraction: results from the FLAGSHIP studyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-10-02Full publication date if available
- Authors
-
Kenta Kamisaka, Kuniyasu Kamiya, Kotaro Iwatsu, Naoki Iritani, Shota Imoto, Takuji Adachi, Yuki Iida, Sumio YamadaList of authors in order
- Landing page
-
https://doi.org/10.1002/ehf2.13619Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1002/ehf2.13619Direct OA link when available
- Concepts
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Medicine, Hazard ratio, Interquartile range, Ejection fraction, Heart failure, Internal medicine, Proportional hazards model, Body mass index, Confidence interval, Heart failure with preserved ejection fraction, Obesity paradox, Cardiology, Odds ratio, Weight loss, Obesity, Natriuretic peptide, OverweightTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
21Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 4, 2024: 4, 2023: 6, 2022: 6, 2021: 1Per-year citation counts (last 5 years)
- References (count)
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31Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.adjustment | 323 |
| abstract_inverted_index.associated | 167, 177, 213, 250, 301, 357 |
| abstract_inverted_index.confidence | 224 |
| abstract_inverted_index.considered | 339 |
| abstract_inverted_index.databases. | 104 |
| abstract_inverted_index.discharge. | 116, 149 |
| abstract_inverted_index.identified | 101 |
| abstract_inverted_index.management | 371 |
| abstract_inverted_index.monitoring | 344 |
| abstract_inverted_index.prevalence | 182 |
| abstract_inverted_index.prognostic | 8, 22 |
| abstract_inverted_index.regression | 151, 157 |
| abstract_inverted_index.Conclusions | 334 |
| abstract_inverted_index.all‐cause | 137, 303 |
| abstract_inverted_index.antagonists | 257, 268 |
| abstract_inverted_index.appropriate | 369 |
| abstract_inverted_index.association | 62 |
| abstract_inverted_index.confounders | 325 |
| abstract_inverted_index.independent | 163 |
| abstract_inverted_index.multicentre | 79 |
| abstract_inverted_index.natriuretic | 236 |
| abstract_inverted_index.non‐obese | 72, 203, 210, 327, 350 |
| abstract_inverted_index.vasopressin | 266 |
| abstract_inverted_index.1.08–9.76, | 261 |
| abstract_inverted_index.1.17–4.60, | 241 |
| abstract_inverted_index.1.22–4.68, | 227 |
| abstract_inverted_index.1.38–5.01, | 318 |
| abstract_inverted_index.2.03–21.2, | 272 |
| abstract_inverted_index.2.08–12.5, | 308 |
| abstract_inverted_index.follow‐up, | 192, 280, 288 |
| abstract_inverted_index.follow‐up. | 373 |
| abstract_inverted_index.hospitalized | 87 |
| abstract_inverted_index.proportional | 155, 296 |
| abstract_inverted_index.respectively. | 205 |
| abstract_inverted_index.(interquartile | 94 |
| abstract_inverted_index.person‐years | 278, 287 |
| abstract_inverted_index.unestablished. | 34 |
| abstract_inverted_index.hospitalization | 216 |
| abstract_inverted_index.mineralocorticoid | 255 |
| abstract_inverted_index.rehospitalization | 141, 292, 314 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 89 |
| corresponding_author_ids | https://openalex.org/A5035156629 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 8 |
| corresponding_institution_ids | https://openalex.org/I60134161 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8600000143051147 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.91530385 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |