Key result
Higher BMI linked to ~4% fewer hospitalizations per 1 kg/m² in HFrEF.
Why the study?
The association between BMI and clinical outcomes in patients with HFrEF remains controversial.
Does higher body mass index reduce the number of all-cause hospitalizations during the preceding 12 months in adults with heart failure with reduced ejection fraction (LVEF ≤40%)?
Cross-Sectional (n=351)
No
Does higher body mass index reduce the number of all-cause hospitalizations during the preceding 12 months in adults with heart failure with reduced ejection fraction (LVEF ≤40%)?
In patients with HFrEF, a higher BMI showed a weak, statistically significant inverse association with all-cause hospitalization counts over the prior 12 months, though the modest effect size and retrospective cross-sectional design preclude causal inference regarding the obesity paradox.
Answers are grounded in this paper and cite their sources.
Should not alter HFrEF management; leaves open whether BMI influences future hospitalizations.
Objective: The association between body mass index (BMI) and clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF) remains controversial.This study evaluated the association between BMI and the number of hospitalizations during the 12 months preceding the index evaluation. Materials and Methods:This single-center, retrospective cross-sectional study included 351 adults with HFrEF and a documented left ventricular ejection fraction (LVEF) ≤40% who were evaluated at Ergani State Hospital between January 1, 2024, and December 31, 2025.The index date was defined as the first eligible evaluation during the study period at which anthropometric, clinical, and echocardiographic data were available.The primary outcome was defined as the total number of all-cause inpatient admissions recorded in the 12 months before the index date.The relationship between BMI and hospitalization count was evaluated using Spearman's rank correlation, followed by univariable and multivariable Poisson regression analyses.In the multivariable analysis, adjustments were made for age, sex, LVEF, diabetes mellitus, chronic kidney disease, and coronary artery disease.Results: The mean age was 64.8±14.3years, 220 patients (62.7%) were men, and the mean BMI was 27.3±3.8kg/m 2 .The median number of hospitalizations during the preceding 12 months was 1 (interquartile range, 0-1).BMI was weakly and inversely correlated with hospitalization count (Spearman ρ=-0.107;p=0.046).In univariable Poisson regression analysis, higher BMI was associated with a lower expected number of hospitalizations [incidence rate ratio (IRR)=0.963;95% confidence interval (CI), 0.931-0.997;p=0.034].In the multivariable model, the inverse association remained statistically significant after adjustment for age, sex, LVEF, diabetes mellitus, chronic kidney disease, and coronary artery disease (adjusted IRR=0.960;95% CI, 0.924-0.999;p=0.042).Conclusion: BMI showed a weak inverse association with the number of hospitalizations during the preceding 12 months among patients with HFrEF, and this association persisted after adjustment for selected clinical covariates.Given the modest effect size and the uncertain temporal relationship between BMI and prior hospitalizations, this finding should not be considered evidence of a protective or causal effect associated with higher BMI.
No takes yet. Share an insight, caveat, or question.
Mehmet Sait Coşkun (2026) conducted a cross-sectional in Heart failure with reduced ejection fraction (HFrEF) (n=351). Body mass index (BMI, per 1 kg/m² increase) vs. Lower body mass index (continuous measure) was evaluated on Total number of all-cause inpatient hospitalizations during the 12 months preceding the index date (Adjusted IRR 0.960, 95% CI 0.924-0.999, p=0.042). Higher body mass index was weakly associated with fewer hospitalizations in the preceding 12 months among patients with HFrEF.
Synapse has enriched 10 related papers. Consider them for comparative context: