{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:11:04Z","timestamp":1774383064345,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011725","name":"Servier","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to assess heart failure (HF) treatment in patients with and without obesity in a large contemporary real\u2010world Western European cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with a left ventricular ejection fraction (LVEF) &lt;50% and available information on body mass index (BMI) were selected from the CHECK\u2010HF registry. The CHECK\u2010HF registry included chronic HF patients in the period between 2013 and 2016 in 34 Dutch outpatient clinics. Patients were divided into BMI categories. Differences in HF medical treatment were analysed, and multivariable logistic regression analysis (dichotomized as BMI &lt;30\u2009kg\/m<jats:sup>2<\/jats:sup> and \u226530\u2009kg\/m<jats:sup>2<\/jats:sup>) was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven thousand six hundred seventy\u2010one patients were included, 1284 (16.7%) had a BMI \u226530\u2009kg\/m<jats:sup>2<\/jats:sup>, and 618 (8.1%) had a BMI \u226535\u2009kg\/m<jats:sup>2<\/jats:sup>. Median BMI was 26.4\u00a0kg\/m<jats:sup>2<\/jats:sup>. 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\u2010directed 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\u2010recommended target dose. In multivariable logistic regression, obesity was significantly associated with a higher likelihood of receiving \u2265100% of the guideline\u2010recommended target dose of beta\u2010blockers (OR 1.34, 95% CI 1.10\u20131.62), renin\u2013angiotensin system (RAS)\u2010inhibitors (OR 1.34, 95% CI 1.15\u20131.57) and MRAs (OR 1.40, 95% CI 1.04\u20131.87).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Guideline\u2010recommended HF drugs are more frequently prescribed and at a higher dose in patients with obesity as compared to HF patients without obesity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13976","type":"journal-article","created":{"date-parts":[[2023,2,26]],"date-time":"2023-02-26T08:38:09Z","timestamp":1677400689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Heart failure treatment in patients with and without obesity with an ejection fraction below 50%"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0749-6902","authenticated-orcid":false,"given":"Yaar S.","family":"Aga","sequence":"first","affiliation":[{"name":"Department of Cardiology, Thoraxcenter Erasmus University Medical Centre  Rotterdam The Netherlands"},{"name":"Department of Cardiology, Thoraxcenter, Franciscus Gasthuis &amp; Vlietland, Rotterdam  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumant P.","family":"Radhoe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoraxcenter Erasmus University Medical Centre  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoraxcenter Erasmus University Medical Centre  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. C. M.","family":"Linssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuisgroep Twente, Almelo and Hengelo  Almelo The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip C.","family":"Rademaker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, ZorgZaam Ziekenhuis  Terneuzen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter R.","family":"Geerlings","sequence":"additional","affiliation":[{"name":"Department of Cardiology St Jans Gasthuis  Weert The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco W. F.","family":"van\u00a0Gent","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Albert Schweitzer Ziekenhuis  Dordrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Admiraal De Ruyter Ziekenhuis  Goes The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liane","family":"Oosterom","sequence":"additional","affiliation":[{"name":"Department of Cardiology Noordwest Ziekenhuis Groep  Alkmaar The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans\u2010Peter","family":"Brunner\u2010La\u00a0Rocca","sequence":"additional","affiliation":[{"name":"Department of Cardiology Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas 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