Heart failure treatment in patients with and without obesity with an ejection fraction below 50%

BackgroundThe aim of this study was to assess heart failure (HF) treatment in patients with and without obesity in a large contemporary real-world Western European cohort. MethodsPatients with a left ventricular ejection fraction (LVEF) = 30 kg/m(2)) was performed. ResultsSeven thousand six hundred seventy-one patients were included, 1284 (16.7%) had a BMI >= 30 kg/m(2), and 618 (8.1%) had a BMI >= 35 kg/m(2). Median BMI was 26.4 kg/m(2). Patients with obesity were younger and had a higher rate of comorbidities such as diabetes mellitus, hypertension and obstructive sleep apnoea (OSAS). Prescription rates of guideline-directed medical therapy (GDMT) increased significantly with BMI. The differences were most pronounced for mineralocorticoid receptor antagonists (MRAs) and diuretics. Patients with obesity more often received the guideline-recommended target dose. In multivariable logistic regression, obesity was significantly associated with a higher likelihood of receiving >= 100% of the guideline-recommended target dose of beta-blockers (OR 1.34, 95% CI 1.10-1.62), renin-angiotensin system (RAS)-inhibitors (OR 1.34, 95% CI 1.15-1.57) and MRAs (OR 1.40, 95% CI 1.04-1.87). ConclusionsGuideline-recommended HF drugs are more frequently prescribed and at a higher dose in patients with obesity as compared to HF patients without obesity