Weight gain worsens post-discharge prognosis in acute HF

(HealthDay)—For patients with acute heart failure (AHF) who experience minimal weight loss or weight gain, increasing body weight is associated with worse post-discharge prognosis, according to research published in the Jan. 1 issue of JACC: Heart Failure.

Andrew P. Ambrosy, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues conducted a post-hoc analysis of the Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure trial to examine body weight changes during and after hospitalization for AHF. Data were included for 4,172 patients with complete body weight data.

The researchers found that the median change in body weight was −1.0 and −2.3 kg at 24 hours and by discharge/day 10, respectively. For patients showing weight loss ≤1 kg or weight gain during hospitalization, increasing body weight during hospitalization correlated with an increase per kg in the odds of 30-day mortality or heart failure readmission, after risk adjustment (odds ratio, 1.16). Increasing body weight correlated with a higher risk of 180-day mortality among the subset of patients experiencing >1-kg increase in body weight after discharge (hazard ratio, 1.16).

"A substantial number of patients experienced minimal weight loss or frank weight gain in the context of an AHF trial, and increasing body weight in this subset of patients was independently associated with a worse post-discharge prognosis," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.