Association between obesity paradox in the all-cause mortality among patients with cardiac resynchronization therapy device.

Autor: Wattanachayakul P; Department of Medicine, Jefferson Einstein Hospital, Philadelphia, Pennsylvania, USA.; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Yanpiset P; Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA., Wannaphut C; Department of Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, USA., Suenghataiphorn T; Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Rujirachun P; Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Danpanichkul P; Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA., Polpichai N; Department of Medicine, Weiss Memorial Hospital, Chicago, Illinois, USA., Saowapa S; Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA., Kewcharoen J; Division of Cardiology, University of California San Francisco, San Francisco, California, USA., Charoenngam N; Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Ungprasert P; Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio, USA.
Jazyk: angličtina
Zdroj: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2024 Nov; Vol. 47 (11), pp. 1464-1473. Date of Electronic Publication: 2024 Sep 09.
DOI: 10.1111/pace.15069
Abstrakt: Background: Recent studies have demonstrated an obesity paradox, where obese patients with cardiovascular disease have a better outcome compared to those with normal weight. However, the effect of obesity and body mass index (BMI) on the outcome of patients with cardiac resynchronization therapy (CRT) devices remains unclear. The current study aims to investigate this relationship using all available published data.
Methods: We systematically reviewed studies from Medline and EMBASE databases from inception to January 2024. Eligible studies must investigate the association between BMI status and all-cause mortality in individuals with CRT devices. Relative risk (RR) or hazard ratio (HR) and 95% CIs were retrieved from each study and combined using the generic inverse variance method.
Results: A total of 12 cohort studies were included in the meta-analysis. Pooled analysis showed that overweight and obesity patients had lower all-cause mortality compared to those with normal body weight with the pooled risk ratios (RR) for overweight of 0.77 (95% CI 0.69-0.87, I 2 47%) and for obesity of 0.81 (95% CI 0.67-0.97, I 2 59%). Conversely, the underweight exhibited higher all-cause mortality than the group with normal weight, with a pooled RR of 1.37 (95% CI 1.14-1.64, I 2 0%). Additionally, higher BMI as continuous data was associated with decreased all-cause mortality, with a pooled HR of 0.94 (95% CI 0.89-0.98, I 2 72%).
Conclusions: The pooled analyses observed an obesity paradox in patients with CRT, where overweight and obesity were associated with reduced all-cause mortality, while underweight individuals exhibited higher all-cause mortality. Further research is necessary to investigate the underlying mechanisms and their implications for clinical practice.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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