Weight changes after hospitalization for worsening heart failure and subsequent re-hospitalization and mortality in the EVEREST trial

• Published in: European heart journal Vol. 30; no. 13; pp. 1666 - 1673
• Main Authors: Blair, John E.A., Khan, Sadiya, Konstam, Marvin A., Swedberg, Karl, Zannad, Faiez, Burnett, John C., Grinfeld, Liliana, Maggioni, Aldo P., Udelson, James E., Zimmer, Christopher A., Ouyang, John, Chen, Chien-Feng, Gheorghiade, Mihai
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2009; Oxford Publishing Limited (England)
• Subjects: Aged; Antidiuretic Hormone Receptor Antagonists; Benzazepines - therapeutic use; Body weight; Disease Progression; Epidemiologic Methods; Female; Heart Failure - drug therapy; Heart Failure - mortality; Heart Failure - physiopathology; Heart failure hospitalizations; Hospitalization; Humans; Male; Middle Aged; Outcomes; Patient Readmission; Prognosis; Treatment Outcome; Weight Gain; Heart failure hospitalizations; Body weight; Outcomes
• ISSN: 0195-668X; 1522-9645; 1522-9645
• DOI: 10.1093/eurheartj/ehp144

Aims Increases in body weight (BW) are important determinants for hospitalization in ambulatory patients with heart failure (HF), but have not yet been explored in patients hospitalized for worsening HF. We explore the relationship between change in BW after hospitalization for worsening HF and risk for repeat hospitalization and mortality in the EVEREST trial. Methods and results The EVEREST trial randomized 4133 patients hospitalized for worsening HF and low ejection fraction (≤40%) to tolvaptan, a vasopressin antagonist, or placebo. Following discharge, BW was assessed at 1, 4, and 8 weeks, and every 8 weeks thereafter. A time-dependent Cox proportional Hazard model explored the relationship between change in BW at 60, 120, and 180 days from discharge and the risks of HF hospitalization, cardiovascular (CV) hospitalization, and all-cause mortality. For subjects re-hospitalized for heart failure at 60, 120, and 180 days after discharge, mean BW increase prior to the event was 1.96, 2.07, and 1.97 kg, respectively, compared with 0.74, 0.90, and 1.04 kg in patients without re-hospitalization (P < 0.001 all groups). A similar pattern was observed with CV hospitalization. However, increases in BW were not predictive of all-cause mortality. Conclusion Increases in BW after hospitalization for worsening HF was predictive of repeat hospitalization events, but not mortality in the post-discharge period.