Er time (Figure 2A), but such differences weren’t observed within the BMI-stratified analysis. Table 4 shows univariate analysisand multivariate Cox regression analysis results for all-cause mortality, including nutritional parameters along with other clinical variables. In the univariate evaluation, serum creatinine levels, LVEF, and NYHA class were related with danger, but TSF was the single best predictor of mortality [hazard ratio (HR) = 0.36; 95 self-confidence interval (CI) = 0.14?.91; p = 0.03]. Ultimately, right after adjustment for these clinical traits, TSF remained a significant independent predictor of general mortality (HR = 0.36; 95 CI = 0.13?.97).DiscussionDespite the growing interest in the obesity paradox, there is nevertheless an ongoing debate concerning probably the most acceptable parameter(s) to assess the nutritional status of HF sufferers. Our outcomes demonstrated that among a lot of anthropometric indices (BMI, BSA, PI, TSF, WC, and AC), TSF was the only parameter that could differentiate survivors from non-survivors inside a modern “real-world” prospective cohort of HF individuals. This discovering is in agreement with the idea of reverse epidemiology, as HF sufferers in the highest TSF quintile had reduced general mortality, even immediately after adjustment for other vital clinical predictors of threat. We didn’t observe a dose esponse relationship involving TSF and mortality, as only the superior quintile, representing a higher volume of fat mass, appeared to become an independent protective aspect. Also, as opposed to other research, we did not find BMI as an adequate predictor of HF prognosis. The correlation among BMI and HF survival remains controversial. Post-hoc evaluation of substantial clinical trials19 demonstrated that decrease BMI was related with decreased survival. Symptomatic HF patients evaluated within the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity trial with either lowered or preserved LV systolicTable three – Comparison of clinical and nutritional characteristics amongst quintiles of TSFQ1 (69) 8,1 Age (years) Gender (male) Etiology Ischemic Hypertensive Idiopathic Alcoholic Other NYHA class I-II III-IV Systolic blood pressure (mmHg) Creatinine (mg/dL) Na (mEq/L) Left Ventricle Ejection fraction ( ) Physique mass index (kg/m? Triceps skinfold (mm) Arm muscle circumference (cm) Waist circumference (cm) 63 (91) six (9) 120 ?22 1.6-Bromo-4-chloro-1H-indole Chemscene four ?0.6-Bromo-8-fluoroisoquinoline Price 7 140 ?4 30 ?9 22 ?2 five.PMID:24423657 8 ?1.five 25 ?3 88 ?9 58 (83) 12 (17) 123 ?20 1.three ?0.four 141 ?3 31 ?9 24 ?three 9.5 ?0.7 26 ?3 94 ?ten 55 (81) 13 (19) 126 ?25 1.2 ?0.5 140 ?three 31 ?eight 25 ?four 12 ?0.9 27 ?three 97 ?11 59 (85) ten (14) 128 ?21 1.0 ?0.four 141 ?4 35 ?9 26 ?four 17 ?1.7 26 ?3 98 ?13 51 (75) 17 (25) 127 ?22 1.0 ?0.4 140 ?three 35 ?ten 31 ?6 27 ?six 26 ?four 103 ?14 0.15 0.001 0.42 0.004 0.001 0.001 0.95 0.001 22 (34) 15 (23) 10 (15) 11 (17) 7 (11) 27 (40) 13 (18) 6 (8) 13 (19) ten (14) 22 (33) 11 (17) 15 (23) 9 (14) 9 (14) 24 (35) 16 (23) 15 (22) 3 (4) 10 (15) 23 (35) 14 (21) 11 (16) 2 (3) 16 (26) 0.06 63 ?15 61 (88) Q2 (70) eight,2?0,5 62 ?9 61 (87) Q3 (68) 10,6?4,2 57 ?11 52 (76) Q4 (69) 14,3?9,9 59 ?14 35 (50) Q5 (68) 20 55 ?13 15 (22) p 0.004 0.001 0.Information are expressed as means ?common deviations or absolute numbers ( ). NYHA: New York Heart Association.Arq Bras Cardiol. 2013;101(5):434-Zuchinali et al. Triceps skinfold measurement and mortality in heart failureOriginal Articlep=0.p=0.Figure 1 – HF hospitalization and general mortality rates as outlined by quintiles of TSF (mm). The p-value represents the difference within the 5th quintil.
