Key result
Overweight and obesity linked to ~56% lower all-cause mortality in NICM patients with an ICD.
Why the study?
Previous studies reported inconsistent results on the relationship between BMI and clinical outcomes in ICD patients, with a lack of research on NICM patients.
Does overweight and obesity reduce mortality in nonischemic cardiomyopathy patients with an implantable cardioverter defibrillator?
Cohort (n=480)
Does overweight and obesity reduce mortality in nonischemic cardiomyopathy patients with an implantable cardioverter defibrillator?
Hazard Ratio: 0.44 (95% CI 0.26–0.77)
p-value: p=0.003
Overweight and obesity are associated with a significantly lower risk of all-cause mortality in patients with nonischemic cardiomyopathy and an ICD, highlighting an obesity paradox in this population.
Overweight/obesity was associated with lower mortality but neutral VA risk in NICM ICD patients; hypothesis-generating and requires prospective validation.
Background Previous studies have reported inconsistent results on the relationship between body mass index (BMI) and clinical outcomes in implantable cardioverter defibrillator (ICD) patients. Additionally, research on ICD patients with nonischemic cardiomyopathy (NICM) is lacking. Hypothesis This study aimed to investigate the impact of BMI on mortality and ventricular arrhythmias (VAs) in NICM patients with an ICD. Methods This study retrospectively analyzed the data from the Study of Home Monitoring System Safety and Efficacy in Cardiac Implantable Electronic Device‐implanted patients (SUMMIT) in China. Four hundred and eighty NICM patients with an ICD having BMI data were enrolled. Patients were divided into two groups: underweight and normal range group (BMI < 24 kg/m2), overweight and obese group (BMI≥24 kg/m2). The primary endpoint was all‐cause mortality. The secondary endpoint was the first occurrence of VAs requiring appropriate ICD therapy or shock. Results During a median follow‐up of 61 (1‐95) months, 70 patients (14.6%) died, 173 patients (36%) experienced VAs requiring appropriate ICD therapy, and 112 patients (23.3%) were treated with ICD shock. Multivariate Cox regression modeling indicated a decreased mortality risk in the overweight and obese group compared with the underweight and normal range group (hazard ratio = 0.44, 95% confidence interval 0.26‐0.77, P = .003). However, the risk of VAs was similar in both groups in univariate and multivariate Cox models. Conclusions Compared with underweight and normal weight, overweight and obesity are protective against mortality but have only a neutral impact on VAs risk in NICM patients with an ICD.
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Zhao et al. (2020) conducted a cohort in Nonischemic cardiomyopathy (NICM) with an implantable cardioverter defibrillator (ICD) (n=480). Overweight and obesity (BMI ≥ 24 kg/m2) vs. Underweight and normal range (BMI < 24 kg/m2) was evaluated on All-cause mortality (HR 0.44, 95% CI 0.26-0.77, p=0.003). Overweight and obesity were associated with a decreased risk of all-cause mortality compared to underweight and normal weight in NICM patients with an ICD (HR 0.44; 95% CI 0.26-0.77; P=0.003).
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