Heart failure & cardiomyopathiesCohort study
Weight loss as a marker of successful decongestion during acute heart failure hospitalisation
- nationwide cohort
- Swedish Heart Failure Registry (2017-2021)
Authors' conclusion
In this nationwide cohort of patients hospitalised for HF and treated with intravenous loop diuretics, diuretic-induced weight loss, a pragmatic marker of decongestion, was associated with improved short-term clinical outcomes without an accompanying decline in renal function and irrespective of biomarker changes, including worsening renal function.
Study context
- Population
- Patients hospitalised for heart failure (HF) who received intravenous loop diuretics, survived to discharge and had body weight recorded at admission and dischargemedian age 80 years, 57% male
- Participants
- 4,979 patients
- Exposure
- Weight loss ≥2 kg between admission and discharge and outcomes
- Weight loss ≥2 kgn = 2,949
- Outcome
- Rehospitalisation for HF (re-HHF)
- Follow-up
- Within 30 days
Main finding
As reported in the abstract
Hazard ratio
0.59
95% CI 0.53–0.67
Observational data: associations, not effects.
Secondary outcomes
Composite of cardiovascular death or rehospitalisation for HF (re-HHF) · within 30 days
| Comparison | HR (95% CI) | |
|---|---|---|
| Weight loss · lower risk; not thereafter | 0.76 (0.69–0.84) | |
| 0.512Hazard ratio (log scale) |
- Composite of cardiovascular death or re-HHF: consistent irrespective of biomarker changes, including worsening renal function
Weight change during hospitalisation
- median weight change
- −2.5 kg
- achieved weight loss ≥2 kg
- 2949 (59%)
Factors associated with weight loss
- Male sex, atrial fibrillation, obesity, higher admission NT-proBNP and mineralocorticoid receptor antagonist use independently associated with weight loss
Change in estimated glomerular filtration rate (eGFR)
- Weight change showed no meaningful association with change in eGFR
Original publication
Summarised from the published abstract; every number is checked against it