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Obesity is a well-known risk factor for cardiovascular diseases including heart failure (HF). However, some literatures suggested better clinical outcomes in obese patients with HF. Since higher body mass index (BMI) levels of HF patients were significantly associated with younger age, the impact of obesity on clinical outcomes in non-elderly HF patients should be elucidated.Consecutive 155 non-elderly acute decompensated HF patients (&lt; 60-year-old) who admitted to our institution between 2009 and 2013 were included. Those patients were divided into the two groups according to the BMI: the obesity group (BMI ≥ 25 kg/m 2 , n = 81) and the non-obesity group (BMI &lt; 25 kg/m 2 , n = 74). The primary composite outcome of this study was defined as re-admission due to HF and all-cause death.The primary composite outcome was less frequently observed in the obesity group as compared with the non-obesity group (Hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.26-0.95, P = 0.03). Re-admission due to HF was significantly less in the obesity group than in the non-obesity group (HR 0.44, 95% CI 0.23-0.86, P = 0.02), whereas all-cause death was not significantly different between the groups (P = 0.44).The mid-term outcomes in non-elderly HF patients with obesity were better as compared with non-elderly HF patients without obesity, which supports obesity paradox in this specific population.

Clinical Characteristics and Mid-Term Outcomes of Non-Elderly Obese Patients with Acute Decompensated Heart Failure in Japan