Incidence of atrial and ventricular arrhythmias in obese patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan
Authors' conclusion
The incidence of congestion in obese patients was higher compared with non-obese patients. LVEF improved significantly more in non-obese compared with obese HFrEF patients. Furthermore, AF and the ventricular tachyarrhythmia rate were revealed more in obesity compared with those without obesity at the 12-month follow-up.
Study context
- Population
- Consecutive patients with heart failure and reduced ejection fraction (HFrEF) initiating angiotensin-receptor neprilysin inhibitor (ARNI), University Medical Center Mannheim, 2016–2020
- Participants
- 208 consecutive patients
- Exposure
- Body mass index (BMI) ≥ 30 kg/m² vs BMI < 30 kg/m² in HFrEF patients treated with ARNI
- BMI ≥ 30 kg/m²n = 92
- BMI < 30 kg/m²n = 116reference
- Outcome
- Clinical outcomes, including mortality rate, all-cause hospitalizations and congestion
- Follow-up
- 12-month follow-up
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
P = 0.76
Observational data: associations, not effects.
Further findings
All-cause hospitalization before ARNI treatment · comparable in both groups
P = 0.69
Hospitalization rate after ARNI treatment · 12-month follow-up · comparable in both groups
P = 0.73
Congestion · follow-up · more congestion in obese, not statistically significant
P = 0.11
Median
| Outcome | BMI < 30 kg/m² | BMI ≥ 30 kg/m² | P value |
|---|---|---|---|
| LVEF at baseline | 26% (range 3%–45%) | 29% (range 10%–45%) | P = 0.56 |
| LVEF · 12-month follow-upImproved significantly more in non-obese | 35.5% (range 15%–59%) | 30% (range 13%–50%) | P = 0.03 |
- Atrial fibrillation (AF) after sacubitril/valsartan · 12-month follow-up — AF, non-obese vs obese · less in non-obese than obese
- 43.5% vs. 53.7% · P = 0.20
- Non-sustained ventricular tachycardia (VT) after sacubitril/valsartan · 12-month follow-up — nsVT, non-obese vs obese · less in non-obese than obese
- 9.8% vs. 28.4% · P = 0.01
- Sustained VT after sacubitril/valsartan · 12-month follow-up — VT, non-obese vs obese · less in non-obese than obese
- 14.1% vs. 17.9% · P = 0.52
- Ventricular fibrillation (VF) after sacubitril/valsartan · 12-month follow-up — VF, non-obese vs obese · less in non-obese than obese
- 7.6% vs. 13.4% · P = 0.23
Original publication
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