Methods. 200 patients with CHF (130 males and 70 females, mean age was 61.5±9.6 years) were studied. CHF was defined according to ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, 2016. Age-adjusted Charlson Comorbidity Index (ACCI) was estimated. The studied patients were divided into 3 groups: I group (low comorbidity) with an index = 3 scores; II group (moderate comorbidity) with an index 4-5 scores and III group (high comorbidity) with an index = 6 scores. Follow-up period was 12 months.
Results. Age-adjusted Charlson Comorbidity Index was 5.0±2.1 scores. Metabolic syndrome was observed in 89 (43.8%) patients, obesity with a BMI = 30 kg/m2 - 97 (48.5%), overweight - 62 (31.0%) patients with CHF. Metabolic syndrome was diagnosed more often in patients with CHF with low comorbidity compared patients with high comorbidity: 38 (71.6%) vs 24 (31.2%), resp., ?2 =19.05; PI-III=0.009. Waist circumference in CHF patients with high comorbidity was less than in patients with low comorbidity: 100.4±15.6 vs 106.8±14.5 cm, resp., PIII-I=0.01. Patients with CHF and low comorbidity had higher body mass index compared with patients with high comorbidity: 32.1±6.1 vs 28.9 ± 5.5 kg/m2, resp., PI-III=0.04. Relative risk of death within 12 months in patients with CHF and high comorbidity was 1.68 (95% CI 1.35 - 2.09) in comparison with patients with low comorbidity. According to the results of our study, patients with CHF and higher body mass have lower comorbidity, i.e. more favorable long-term prognosis.
Conclusions. Patients with chronic heart failure and high comorbidity have lower body mass index, higher waist circumference and a poor prognosis compared with patients with chronic heart failure and low comorbidity . This fact may be one explanation for the «obesity paradox» in patients with chronic heart failure.